Katherine A Bolsen, HSPP

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

License

20043271A Issued in IN

Practice address

415 N 26TH St
Lafayette, IN 47904-2895

Phone

(765) 446-6535

Fax

(765) 446-3536

NPI assigned

Aug 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Katherine Earl Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1326529306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N 26TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042895",
            "telephone_number": "765-446-6535",
            "fax_number": "765-446-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 26TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042895",
            "telephone_number": "765-446-6535",
            "fax_number": "765-446-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLSEN",
        "first_name": "KATHERINE",
        "middle_name": "A",
        "credential": "HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IN",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IN",
            "license": "20043271A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "EARL",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Noelle K Boehle, CST
• Michael D. Bohlin, M.D.
• Islam Abbas Bolad, MD
• Emma Elizabeth Boles
• Riley Bolin, BCBA
• Christine D Bolton, O.D.
• Michael Bolton Jr.
• Katherine L Bolyard, PH.D.
• Shelley F Boniello, LMHC
• Kathryn Rebecca Bontrager, PA-C

• Health Service Psychologist in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Health Service Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.