Marquita Janinne Bolden, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW016920 Issued in PA

Practice address

8302 Old York Rd Ste B1
Elkins Park, PA 19027-1529

Phone

(267) 227-0122

NPI assigned

Dec 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marquita Janinne Earl Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mosaic Bloom Counseling LLC

  • Clinical Social Worker
  • Elkins Park, PA
  • NPI 1851073241
  NPD Authorized official

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1801079009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8302 OLD YORK RD STE B1",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271529",
            "telephone_number": "267-227-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8302 OLD YORK RD STE B1",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271529",
            "telephone_number": "267-227-0122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 S 17th St",
            "address_2": "Suite 1010",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191036231",
            "country_code": "US",
            "telephone_number": "215-732-6308",
            "fax_number": "215-732-8240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "MARQUITA",
        "middle_name": "JANINNE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARQUITA",
            "last_name": "EARL",
            "middle_name": "JANINNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ruth Bluethenthal-Appel, LCSW, CERTIFIED CFT
• Yale Robert Bobrin, D.O.
• Body and Soul Inc.
• Melissa Boehmer, M.S., CCC-SLP
• Linda Bojman, MS,RD,LDN
• Bon Vivant Safety Eyewear Company Inc (LensRx Lab)
• Lindsay Marie Bondurant, PH.D., CCC-A
• Sanjeev Bongu, M.D.
• Jerrold Charles Bonn, M.D.
• Robert Bonnem

• Clinical Social Worker in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.