Carolyn R Boldman, LICDC, LPC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LICDC.162231 Issued in OH

Practice address

126 E 2ND St
Chillicothe, OH 45601-2593

Phone

(513) 834-7063

NPI assigned

Nov 7, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Radley Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cincinnati, OH
  • NPI 1568260479
  Medicare reassignment NPD
• Community Mental Health Centers of Warren County, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lebanon, OH
  • NPI 1740278381
  NPD (past)
• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1285030932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021457",
            "telephone_number": "513-834-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E 2ND ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456012593",
            "telephone_number": "513-834-7063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Greenwood Ln",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450663033",
            "country_code": "US",
            "telephone_number": "937-746-1146",
            "fax_number": "937-746-8523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "975 Kingsview Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OH",
            "postal_code": "450369562",
            "country_code": "US",
            "telephone_number": "513-228-7800",
            "fax_number": "513-228-7846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLDMAN",
        "first_name": "CAROLYN",
        "middle_name": "R",
        "credential": "LICDC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-07",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII-161321",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2103914",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Charles Blouir, PA-C
• Vicki Lynn Bodey, RN
• Dexter Lee Boggs, MD
• Jourdan Rey Boggs, RN
• Megan Elizabeth Bohrer, PA-C
• Jason W Bolt, PRS
• Dianne I Bolton
• Aschli Annette Bond
• Kathy Lynn Bond, RN
• Tiffany M Bond

• Addiction (Substance Use Disorder) Counselor in Chillicothe, OH
• Providers in Chillicothe, 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 Feb 17, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.