Active NPI
Charia Monique Bolden, CNA
- Behavior Technician
- St Charles, IL
National Provider Identifier
1841916251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 106S00000X
- Practice address
- 309 Walnut St Ste B
St Charles, IL 60174-2766 - Phone
- (703) 564-1634
- NPI assigned
- Oct 17, 2022
- Last updated
- Oct 17, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 106S00000X | IL | Primary |
Addresses
Primary practice location
309 Walnut St Ste B
St Charles, IL 60174-2766
Mailing address
120 E Park Ave Unit C
Sugar Grove, IL 60554-9102
Phone (630) 803-5682
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
| License | State | Type | Specialty |
|---|---|---|---|
| 106S00000X | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1841916251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 E PARK AVE UNIT C",
"city": "SUGAR GROVE",
"state": "IL",
"postal_code": "605549102",
"telephone_number": "630-803-5682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 WALNUT ST STE B",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601742766",
"telephone_number": "703-564-1634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDEN",
"first_name": "CHARIA",
"middle_name": "MONIQUE",
"credential": "CNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-17",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "106S00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Charles, IL
- Franklin Michael Bodnar, D.C.
- Body Solutions Chiropractic & Rehabilitation Ctr, LTD.
- Bodyworks Medical Center of Geneva PLLC (Bodyworks Medical Center)
- Bodyworks Medical Center of STC LLC
- Jacob Dalton Boehm, PA-C
- Bon DDS Dental Studio PC
- Rona Bongat, COTA/L
- Julie E Bonhotal, SLP
- Ellen Jean Bonine, OTRL
- Sandra Marie Borgstrom
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.