Raylyn Victoria Bollin, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2021004670 Issued in MO

Practice address

668 SE Bayberry LN Ste 101
Lees Summit, MO 64063-4366

Phone

(785) 214-3808

NPI assigned

Feb 8, 2021

Last updated

Feb 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1174115505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 SE BAYBERRY LN STE 101",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640634366",
            "telephone_number": "785-214-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 SE BAYBERRY LN STE 101",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640634366",
            "telephone_number": "785-214-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLIN",
        "first_name": "RAYLYN",
        "middle_name": "VICTORIA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2021004670",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "11737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.