Individual provider Active NPI

Erika K Boland, ED.D.

  • Clinical Psychologist
  • Louisville, KY
National Provider Identifier
1780464602
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
129540 Issued in KY
Practice address
7511 New la Grange Rd
Louisville, KY 40222-4859
Phone
(502) 423-1151
Fax
(502) 423-1748
NPI assigned
Sep 29, 2023
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 129540 KY Primary

Addresses

Primary practice location

7511 New la Grange Rd
Louisville, KY 40222-4859

Mailing address

7511 New la Grange Rd
Louisville, KY 40222-4859
Phone (502) 423-1151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240718004039 KY Practitioner - Clinical Psychologist 6800332495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
129540KYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Edelson and Associates, Inc. CurrentSince Oct 1, 2023 Accepting new patients

Locations

10509 Timberwood Cir
Ste 250
Louisville, KY 40223
Phone (501) 423-1151

7511 New La Grange Rd
Louisville, KY 40222
Phone (502) 423-1151

Organizations & group practices 2

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": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1780464602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7511 NEW LA GRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224859",
            "telephone_number": "502-423-1151",
            "fax_number": "502-423-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7511 NEW LA GRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224859",
            "telephone_number": "502-423-1151",
            "fax_number": "502-423-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "ERIKA",
        "middle_name": "K",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "129540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.