Bolden Therapy & Wellness, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BOLDEN THERAPY & WELLNESS, LLC

Doing business as

Shameka Bolden

Practice address

2000 Kraft Dr Ste 1300
Blacksburg, VA 24060-6162

Phone

(540) 880-2208

Fax

(540) 866-0868

NPI assigned

Nov 3, 2021

Last updated

Aug 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shameka Bolden, LPCNPI 1851919021

Title

Director of Clinical Services

Phone

(540) 880-2208

Specialties & licenses 3

Addresses

Other names 1

• Shameka Bolden Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shameka Hylton Bolden, LPC

  • Professional Counselor
  • Christiansburg, VA
  • NPI 1851919021
  NPD Authorized official
• Antonio Markeith Bolden, LPC

  • Professional Counselor
  • Blacksburg, VA
  • NPI 1386367001
  NPD

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1407511660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 KRAFT DR STE 1300",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240606162",
            "telephone_number": "540-880-2208",
            "fax_number": "540-866-0868"
        },
        {
            "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": "540-880-2208",
            "fax_number": "540-866-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLDEN THERAPY & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-03",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "BOLDEN",
        "authorized_official_first_name": "SHAMEKA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "540-880-2208",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shameka Bolden",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Body Balance Spa, LLC
• Body Balance Therapeutic Massage
• Scott Boerth, M.D.
• Antonio Markeith Bolden, LPC
• Stacey Bolt, LPC
• Hanna Boothe
• Travis Bostic, LPC
• Carrie Elaine Boucher, LMT

• Community/Behavioral Health Agency in Blacksburg, VA
• Providers in Blacksburg, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.