Matthew David Bolin

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26492 Issued in MN

Practice address

800 E 28TH St FL 6
Minneapolis, MN 55407-3723

Phone

(612) 863-5327

Fax

(612) 863-2596

NPI assigned

May 27, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1720654189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST FL 6",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-5327",
            "fax_number": "612-863-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIN",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbolin565284@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "800 E 28th St Fl 6",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554073723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Reghan Maureen Boldt, MOT, OTR/L, CLT
• David Benjamin Boleen
• Bolger Family Counseling, LLC
• Melissa Ann Bolger, LMFT
• Connie J Bolin, CRNA
• Michelle M Bolin, CRNA
• Christine N Boline, APRN
• Karly Anne Boll, MD
• Nicole Bollensen
• Kendra Bollig

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

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

Verify at the official NPI Registry.