Erika K Boland, ED.D.
Individual provider Active NPI Clinical Psychologist · Louisville, KY
NPI 1780464602 · NPPES record last updated Oct 11, 2023
Key facts
- NPI
- 1780464602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 129540 (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
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240718004039 | KY | Practitioner - Clinical Psychologist | 6800332495 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edelson and Associates, Inc. | Current |
Accepting new patients |
Locations
7511 New La Grange Rd
Louisville, KY 40222
Phone (502) 423-1151
10509 Timberwood Cir
Ste 250
Louisville, KY 40223
Phone (501) 423-1151
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 129540 | KY | Yes |
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
NPI Registry JSON
{
"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
- Abdou Bojang
- Omar Bojang
- Kimberly Epperson Bokeno
- Bokhari & Bokhari, PLLC.
- Satheesh Kumar Bokka
- Kimberly A. Boland
- Myrna Lee Boland
- Urban Richard Boland Jr.
- Shaina Danielle Bolden
- Faith Marie Boles
All providers in Louisville, KY · Clinical Psychologist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.