Nicole Bolduc, MSW, LISW-S, LICDC,

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1901415 Issued in OH

Practice address

1331 Conant St Ste 201
Maumee, OH 43537-4214

Phone

(419) 665-1277

NPI assigned

Jan 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

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.

• Bloom & Thrive Wellness, LLC

  • Clinical Social Worker
  • Maumee, OH
  • NPI 1477362192
  NPD Authorized official
• Community Teaching Homes, Inc.

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1306015813
  NPD (past)
• Community Teaching Homes, Inc.

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1528563079
  NPD (past)

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1831556547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 CONANT ST STE 201",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374214",
            "telephone_number": "419-217-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 CONANT ST STE 201",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374214",
            "telephone_number": "419-665-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDUC",
        "first_name": "NICOLE",
        "credential": "MSW, LISW-S, LICDC,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161857",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34008910A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "2394",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1502497",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Bissonnette-Romero, RBT
• Wesley Blank, CDCA
• Heidi Bleyer, BCBA/COBA
• Bloom & Thrive Wellness, LLC
• Bloom Women'S Counseling, Consulting, and Wellness, LLC.
• Thomas C Bolig
• Gina M. Bonino, LSW
• David A Borgman, MBA, MS, PT
• Beau G Bortel, DPM
• Travis Rook Bosma

• Clinical Social Worker in Maumee, OH
• Providers in Maumee, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.