NPIMap

Individual provider Active NPI

Kimberly M Bolland, LCSW-C

  • Clinical Social Worker
  • Hagerstown, MD
National Provider Identifier
1700146172
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14976 Issued in MD
Practice address
10435 Downsville Pike
Hagerstown, MD 21740-1732
Phone
(919) 538-4099
NPI assigned
May 20, 2012
Last updated
Dec 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C007617 NC
Clinical Social Worker 1041C0700X 14976 MD Primary

Addresses

Primary practice location

10435 Downsville Pike
Hagerstown, MD 21740-1732

Mailing address

PO Box 454
Clear Spring, MD 21722-0454

Other practice location 1

3000 Highwoods Blvd Ste 310
Raleigh, NC 27604-1029
Phone (919) 714-7500

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

State licenses

LicenseStateTypeSpecialty
14976MDMDClinical Social Worker
C007617NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Services, LLC Past Accepting new patients
Hope Services, LLC PastSince Sep 13, 2015 Accepting new patients
Board of Education of Washington County Clinical PastSince Sep 12, 2021 Accepting new patients
Washington County Early Intervention PastSince Sep 12, 2021 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1337472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1700146172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 454",
            "city": "CLEAR SPRING",
            "state": "MD",
            "postal_code": "217220454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10435 DOWNSVILLE PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217401732",
            "telephone_number": "919-538-4099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Highwoods Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276041029",
            "country_code": "US",
            "telephone_number": "919-714-7500",
            "fax_number": "919-714-7515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLAND",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-20",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007617",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

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