Jerie Johanna Bolin, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P.08236 Issued in OH

Practice address

117 Health Sciences BLDG
3640 Colonel Glenn Hwy
Dayton, OH 45435

Phone

(937) 775-3458

Fax

(937) 775-3434

NPI assigned

Dec 28, 2017

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tower Moments

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1992683825
  NPD Authorized official

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679184000000",
    "number": "1689180622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8585 REMINGTON HILLS CIR",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "430352529",
            "telephone_number": "859-940-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 HEALTH SCIENCES BLDG",
            "address_2": "3640 COLONEL GLENN HWY",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45435",
            "telephone_number": "937-775-3458",
            "fax_number": "937-775-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIN",
        "first_name": "JERIE",
        "middle_name": "JOHANNA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2023-03-19",
        "certification_date": "2023-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.08236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily E Boldman, PA-C
• Devonee Bolds
• Amy Michelle Bolen, FNP-C
• Cali Boles
• Barbara A Bolia, L.P.N.
• Kyra Bolin
• Michelle N Bolton-Lawson, CDCA
• Barrett Henry Bolton, M.D.
• Ryan Matthew Bolus, PHARMD, BCNP
• Elizabeth Sharpless Bonanno, M.D.

• Clinical Psychologist in Dayton, OH
• Providers in Dayton, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2023; 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.