Kassidee Dawn Boles, LCDC III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCDCIII.162696 Issued in OH

Practice address

15 Frederick Ave
Akron, OH 44310-2904

Phone

(740) 996-7730

NPI assigned

Jan 4, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oriana House, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Akron, OH
  • NPI 1730127176
  NPD (past)
• Oriana House, Inc.

  • Community/Behavioral Health Agency
  • Marietta, OH
  • NPI 1790249431
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1164183935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 E BUCHTEL AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443052338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FREDERICK AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443102904",
            "telephone_number": "740-996-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLES",
        "first_name": "KASSIDEE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "LCDC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2024-05-21",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII.162696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samarya Bolar
• Claire Elizabeth Bolden, PHARMD
• Dionna Bolden
• Yvonne Thersa Bolden, RN CPNP
• Sandra Boldt-Birchfield, RN
• Phil T. Boley
• Shannon Marie Bolinger
• Gary E Bollin, M.D.
• Victoria Bolovan, RN
• John Boltri, MD

• Addiction (Substance Use Disorder) Counselor in Akron, OH
• Providers in Akron, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.