Karissa Bolden, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH15426 Issued in FL

Practice address

5776 NW Zinnia St
Port Saint Lucie, FL 34986-3501

Phone

(949) 702-0918

NPI assigned

Jul 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Karissa Dempsey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Aace Health Network, LLC

  dba AACE Therapy Services

  • Community/Behavioral Health Agency
  • Port St Lucie, FL
  • NPI 1598336604
  NPD Authorized official

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1427667104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5776 NW ZINNIA ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5776 NW ZINNIA ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863501",
            "telephone_number": "949-702-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "KARISSA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISSA",
            "last_name": "DEMPSEY",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blooming Hope Behavioral LLC
• Blue Harmony Therapy Inc
• Michael A Blum, D.O.
• Body Language by Theresa LLC
• Sandra H Bolanos, MD, PHD
• Wesley Bolitho, MS, CCC-SLP
• Kyle Boltson
• Yonahil M Bonalde
• Bonnie'S Group Hpme
• Eduardo F Borges, MD

• Mental Health Counselor in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.