Individual provider Active NPI

Lisa Marie Bollman

  • Professional Counselor
  • Toledo, OH
National Provider Identifier
1831188093
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E0003822 Issued in OH
Practice address
544 E Woodruff Ave
Toledo, OH 43624-1342
Phone
(419) 693-0631
Fax
(419) 936-7606
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E0003822 OH Primary

Addresses

Primary practice location

544 E Woodruff Ave
Toledo, OH 43624-1342

Mailing address

1425 Starr Ave
Toledo, OH 43605-2456

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
E0003822OHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1831188093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 STARR AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436052456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 E WOODRUFF AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436241342",
            "telephone_number": "419-693-0631",
            "fax_number": "419-936-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLMAN",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0003822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.