Elizabeth Jane Bolt, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

003387 Issued in CT

Practice address

Southeastern Mental Health Authority 401 W Thames St
BLDG 301
Norwich, CT 06380

Phone

(860) 859-4674

Fax

(860) 859-4790

NPI assigned

Dec 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• State of Connecticut

  dba Department of Veterans' Affairs, Veterans Home

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD (past)
• State of Connecticut

  dba Southeastern Mental Health Authority

  • Adult Mental Health Clinic/Center
  • Norwich, CT
  • NPI 1902831548
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528128238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SOUTHEASTERN MENTAL HEALTH AUTHORITY 401 W THAMES ST",
            "address_2": "BLDG 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06380",
            "telephone_number": "860-859-4674",
            "fax_number": "860-859-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTHEASTERN MENTAL HEALTH AUTHORITY 401 W THAMES ST",
            "address_2": "BLDG 301",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06380",
            "telephone_number": "860-859-4674",
            "fax_number": "860-859-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLT",
        "first_name": "ELIZABETH",
        "middle_name": "JANE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "003387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Chao Blankenship, D.C. L.AC.
• Kathryn C Boardman, NP
• Harold J Bodin, MD
• Mackenzie Bodnaruk
• Hannah Ryan Bogoian, PH.D.
• Amber Jean Bonchuk
• Stephie Jovanie Bonheur
• Kathleen Bonin, APRN
• Kristin Bonner, LCSW
• Kathryn H Bony, OD

• Social Worker in Norwich, CT
• Providers in Norwich, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.