Kimberly Bolen McGrew, MA, LPA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3605 Issued in NC

Practice address

1213 Culbreth Dr
Suite 125
Wilmington, NC 28405-3639

Phone

(910) 509-7147

Fax

(910) 821-8447

NPI assigned

Aug 19, 2008

Last updated

Jul 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kimberly Rose Bolen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kimberly Bolen, PLLC

  • Psychologist
  • Wilmington, NC
  • NPI 1205274909
  NPD (past) Authorized official

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436572800000",
    "number": "1467609743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 CULLODEN CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284117265",
            "telephone_number": "910-512-2890",
            "fax_number": "910-821-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 CULBRETH DR",
            "address_2": "SUITE 125",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053639",
            "telephone_number": "910-509-7147",
            "fax_number": "910-821-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGREW",
        "first_name": "KIMBERLY",
        "middle_name": "BOLEN",
        "name_prefix": "Mrs.",
        "credential": "MA, LPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2015-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BOLEN",
            "middle_name": "ROSE",
            "prefix": "MISS",
            "credential": "MA, LPA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tyler Monroe McGrady, DO
• Brian James McGrath Jr., D.O.
• Brielle Lynn McGrath, PA-C
• Eric Sean McGraw, D.C.
• Zakia McGregor, LCAS-A
• Janet Mayer McHenry, FNP
• Darcie Marie McHugh, R.N.
• Meredith Sterling-Swain McInnis
• Susan Nicole McInnis, FNP-C
• John Davies McIntyre, MA, LPC-A

• Psychologist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2015; 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.