Vetrice Bolden, CSS

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

122 Desoto Ave
Clarksdale, MS 38614-4420

Phone

(662) 592-5397

NPI assigned

Feb 7, 2025

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

• Mrs. Vetrice Bolden Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 7, 2025.

{
    "created_epoch": "1738886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1386459485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 E RIVER PL STE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392023442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 DESOTO AVE",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386144420",
            "telephone_number": "662-592-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "VETRICE",
        "credential": "CSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VETRICE",
            "last_name": "BOLDEN",
            "prefix": "MRS.",
            "credential": "CSS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Clarksdale, MS
• Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; 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.