Keiryan Ashleigh Bolling, LCSW-C

Primary specialty

Social WorkerTaxonomy code 104100000X

License

21778 Issued in MD

Practice address

6170 Hunt Club Rd
Elkridge, MD 21075-5518

Phone

(443) 328-3088

NPI assigned

Jun 3, 2016

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

Medicare fee-for-service enrollment

Enrolled in MD

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.

• Restoration of Wellness

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1487254272

  MD

  Medicare reassignment Care Compare group NPD
• Protecting Our Peace LLC

  • Community/Behavioral Health Agency
  • Elkridge, MD
  • NPI 1316561921
  NPD Authorized official

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Restoration of Wellness 2 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1629427307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 MARSHALEE DR STE 712",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756086",
            "telephone_number": "443-328-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6170 HUNT CLUB RD",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755518",
            "telephone_number": "443-328-3088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7474 Greenway Center Dr Ste 730",
            "address_purpose": "LOCATION",
            "city": "Greenbelt",
            "state": "MD",
            "postal_code": "207703523",
            "country_code": "US",
            "telephone_number": "301-345-1022",
            "fax_number": "301-560-5558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8602 Lindendale Dr",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207075041",
            "country_code": "US",
            "telephone_number": "443-328-3088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLING",
        "first_name": "KEIRYAN",
        "middle_name": "ASHLEIGH",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "21778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Bloomfield
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• BLS Diagnostics LLC
• Elise Bogard
• Anna Katarzyna Bonney, CRNP-F
• Alexander Sylvain Bopda
• Danielle Chekam Bopda
• Henriette G Bopda
• Priscilla Amfo Bossman, NP-C

• All providers in Elkridge, MD
• Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.