Beth Bolen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

190 E Bannock St
Boise, ID 83712

Phone

(208) 381-2222

Fax

(208) 381-8749

NPI assigned

Aug 25, 2006

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

Other names 1

• Beth Fortuna Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1275640013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 W HAYS, SUITE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837022612",
            "telephone_number": "208-381-7312",
            "fax_number": "208-381-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83712",
            "telephone_number": "208-381-2222",
            "fax_number": "208-381-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLEN",
        "first_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "FORTUNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Boise West Dental Health LLP
• Boise West of Cascadia, LLC
• Boise Women'S Health & Birth Center
• Boise Womens Health & Birth Center
• Sabrina Bojo, AGNP
• Kenna Bolen, LPC, CM, CBRS
• Kevin L Bolen, MS
• Sarah L Bolender, MD
• Neal Boliou, PHY.D.
• Patricia Boliou, LPC

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.