Kylee Waynette Bolibrzuch, MSW

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3027 San Diego Rd
Jacksonville, FL 32207

Phone

(904) 493-8632

NPI assigned

Jun 17, 2018

Last updated

Jun 18, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1529193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1649764309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15856 BAXTER CREEK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188354",
            "telephone_number": "619-886-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3027 SAN DIEGO RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-493-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIBRZUCH",
        "first_name": "KYLEE",
        "middle_name": "WAYNETTE",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-17",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul R Boldt, D.M.D.
• Lucy Bolerjack, DO
• Kathryn Susanne Boles, D.O.
• Rachel Amanda Bolger, PT, DPT
• William E Bolger, M.D.
• Laura Stultz Bolinski
• Kelsey Lyn Bolks, M.A., CCC-SLP
• Rishitha Bollam, MD
• Valdora L Bollenback, D.P.T.
• James Bolling, MD

• Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.