Antonio Markeith Bolden, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701011811 Issued in VA

Practice address

2000 Kraft Dr Ste 1300
Blacksburg, VA 24060-6162

Phone

(540) 392-9228

NPI assigned

Sep 20, 2022

Sex

Male

Sole proprietor

Yes

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

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270

  VA

  Medicare reassignment NPD
• Bolden Therapy & Wellness, LLC

  • Community/Behavioral Health Agency
  • Blacksburg, VA
  • NPI 1407511660
  NPD

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1386367001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 HUFF HERITAGE LN",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240733897",
            "telephone_number": "540-392-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 KRAFT DR STE 1300",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606162",
            "telephone_number": "540-392-9228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 First Colonial Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234543078",
            "country_code": "US",
            "telephone_number": "757-395-1850",
            "fax_number": "757-222-9360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "ANTONIO",
        "middle_name": "MARKEITH",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-20",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701011811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Ridge Optical
• Body Balance Spa, LLC
• Body Balance Therapeutic Massage
• Scott Boerth, M.D.
• Bolden Therapy & Wellness, LLC
• Stacey Bolt, LPC
• Hanna Boothe
• Travis Bostic, LPC
• Carrie Elaine Boucher, LMT
• Richard Prentice Boyle III, DDS

• All providers in Blacksburg, VA
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.