Carolyn Marie Bollinger, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11050-123 Issued in WI

Practice address

8550 Hudson Blvd N Ste 100
Lake Elmo, MN 55042-8706

Phone

(651) 254-8580

Fax

(651) 254-0601

NPI assigned

Dec 2, 2022

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

Enrolled in MN, WI2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Westfields Hospital and Clinic Hospital, New Richmond, WI, CCN 521345

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683

  WI

  Medicare reassignment Care Compare group NPD
• Westfields Hospital, Inc.

  • Critical Access Hospital
  • New Richmond, WI
  • NPI 1881640183
  Medicare reassignment NPD
• Group Health, Inc.

  • Health Service Clinic/Center
  • Waite Park, MN
  • NPI 1457836454
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Group Health, Inc.

  • Family Medicine Physician
  • Somerset, WI
  • NPI 1215305412
  NPD
• Westfields Hospital, Inc

  • Hematology & Oncology Physician
  • Osceola, WI
  • NPI 1477228070
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Westfields Hospital, Inc.

  • Critical Access Hospital
  • New Richmond, WI
  • NPI 1881640183
  Care Compare affiliation

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1316657117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 HUDSON BLVD N STE 100",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428706",
            "telephone_number": "651-254-8580",
            "fax_number": "651-254-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 HUDSON BLVD N STE 100",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428706",
            "telephone_number": "651-254-8580",
            "fax_number": "651-254-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLINGER",
        "first_name": "CAROLYN",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28021",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11050-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James R Benyon, CRNA
• Laura Bergstrom, PA
• Sarah Berkowitz
• Mariel J Blomstrand, MSW LICSW
• Blossom Towne Enterprises
• Mari Boyd, M.A., LMFT
• John Arthur Bragstad, LMFT
• Broadstone Medical, P.C.
• Kent Gregory Brockmann, MD
• Alexandra Nicole Brown, MA, LPCC

• Clinical Social Worker in Lake Elmo, MN
• Providers in Lake Elmo, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.