Active NPI
Michael Bollin
- Professional Counselor
- Charlotte, NC
National Provider Identifier
1538518089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A12265
- Practice address
- 7401 Carmel Executive Park Dr
Suite 210
Charlotte, NC 28226-8275 - Phone
- (585) 245-2188
- NPI assigned
- Jun 6, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A12265 | NC | Primary |
Addresses
Primary practice location
7401 Carmel Executive Park Dr
Suite 210
Charlotte, NC 28226-8275
Mailing address
4125 Double Creek Crossing Dr
Apt. 214
Charlotte, NC 28269-3265
Phone (585) 245-2188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A12265 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465171200000",
"number": "1538518089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4125 DOUBLE CREEK CROSSING DR",
"address_2": "APT. 214",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282693265",
"telephone_number": "585-245-2188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7401 CARMEL EXECUTIVE PARK DR",
"address_2": "SUITE 210",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282268275",
"telephone_number": "585-245-2188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLLIN",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-06",
"last_updated": "2016-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A12265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.