Active NPI
Erica J Bolden
- Mental Health Counselor
- Montoursville, PA
National Provider Identifier
1619689676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 241 Broad St
Montoursville, PA 17754-2283 - Phone
- (570) 327-4913
- NPI assigned
- Dec 21, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
241 Broad St
Montoursville, PA 17754-2283
Mailing address
435 W 4TH St
Williamsport, PA 17701-6001
Phone (570) 494-3120
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Whitede@diakon.org |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1619689676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "435 W 4TH ST",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177016001",
"telephone_number": "570-494-3120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "241 BROAD ST",
"city": "MONTOURSVILLE",
"state": "PA",
"postal_code": "177542283",
"telephone_number": "570-327-4913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDEN",
"first_name": "ERICA",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-21",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Whitede@diakon.org",
"affiliation": "N",
"address_1": "435 W 4th St",
"city": "Williamsport",
"state": "PA",
"country_code": "US",
"postal_code": "177016001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Montoursville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.