Kenyetta Lasyl Bolling, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

19807 Issued in TX

Practice address

7000 NW 100 Dr # B100
Houston, TX 77092-2051

Phone

(713) 462-6060

Fax

(866) 849-5747

NPI assigned

Feb 21, 2007

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)

Enrolled

Credentials

Master of Science

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.

• Tangible Difference Learning Center, LLC

  • Community/Behavioral Health Agency
  • Houston, TX
  • NPI 1255517538
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1174668529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 AKUMAL LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770732912",
            "telephone_number": "281-821-6741",
            "fax_number": "281-449-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 NW 100 DR # B100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770922051",
            "telephone_number": "713-462-6060",
            "fax_number": "866-849-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLING",
        "first_name": "KENYETTA",
        "middle_name": "LASYL",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "19807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia Bollar
• Stephen Bolline, M.D.
• Patrice Bolling-Crier, RN
• Danessa Michelle Bolling, MSW
• Joann Bolling, DC
• April Lyn Bollinger, CRNA
• Christine Bollinger, RN, MS, CPNP
• Madeline Bollinger, LPC-ASSOCIATE
• Lauren Bollman
• Harold Bolnick, MD

• Speech-Language Pathologist in Houston, TX
• Providers in Houston, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.