Amy Catherine Bolkcom, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2828 Kraft Ave SE Ste 186
Grand Rapids, MI 49512-2076

Phone

(616) 949-9550

NPI assigned

Dec 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• New Community Resources

  dba Wellspring Counseling Services

  • Professional Counselor
  • Okemos, MI
  • NPI 1154421824
  Medicare reassignment NPD

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1609587930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11341 TAUNTON DR SE",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493318844",
            "telephone_number": "616-215-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 KRAFT AVE SE STE 186",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122076",
            "telephone_number": "616-949-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLKCOM",
        "first_name": "AMY",
        "middle_name": "CATHERINE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia K Bolen, PA-C
• Laura J Bolenz-Geesin, PA-C
• Payton Rochel Bolin
• Kelli Marie Boling
• Tammy Bolinger, MS, PA-C
• Scott Harvey Bolkema, D.D.S.
• Brooke Ella Bollin-Richards, M.D.
• Elham Bolouri
• Kaylin Joy Bolt, MSW, MPH, MED
• Jonathan Todd Bolthouse, MD

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.