Mary C Bolton, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2219057 Issued in WI

Practice address

10201 W Lincoln Ave
308
West Allis, WI 53227-2136

Phone

(414) 329-7000

Fax

(414) 329-7010

NPI assigned

Aug 31, 2006

Last updated

Feb 11, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stress Management and Mental Health ClinicsGroup PAC ID 8426954066, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stress Management & Mental Health Clinics

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Allis, WI
  • NPI 1003928391
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1841301066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 W LINCOLN AVE",
            "address_2": "308",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272136",
            "telephone_number": "414-329-7000",
            "fax_number": "414-329-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 W LINCOLN AVE",
            "address_2": "308",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272136",
            "telephone_number": "414-329-7000",
            "fax_number": "414-329-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2219057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39144700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Boeker, DDS
• Reed Bogrand, DC
• Amy Lynn Bohler, FNP-BC
• Mark Anthony Boldt, DDS
• Linda Jean Bolton, OTR
• Jordan J Bonnett, AU.D.
• Ashley Lauren Boonnam, FNP-BC
• Catherine M Bopp, PAC
• Hope Borland, NP
• Bret Borowski, M.D.

• Psychologist in West Allis, WI
• Providers in West Allis, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.