Michaela Bolynn, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

11760 Issued in KS

Practice address

149 S Andover Rd Ste 100
Andover, KS 67002-7935

Phone

(316) 247-3063

Fax

(316) 247-6833

NPI assigned

Jul 27, 2021

Last updated

Aug 29, 2024By 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

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

• Andover Family Counseling, LLC

  • Clinical Social Worker
  • Andover, KS
  • NPI 1952804171
  NPD
• Grit and Grace Counsel and Consult

  • Clinical Social Worker
  • Coldwater, KS
  • NPI 1326777129
  NPD (past)

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1871266734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 S ANDOVER RD STE 100",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670027935",
            "telephone_number": "316-247-3063",
            "fax_number": "316-247-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 S ANDOVER RD STE 100",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670027935",
            "telephone_number": "316-247-3063",
            "fax_number": "316-247-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLYNN",
        "first_name": "MICHAELA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "11760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waneko Chantele Bivens, MM, PHD
• Stephanie Danielle Blake, DPT
• Jennifer Lynn Blickenstaff, LCP
• Sarah Blosser, APRN
• Terry Keith Blue, CRNA
• Ryan Bordewick
• Heather Borsdorf
• Lura L Borsdorf, LSCSW
• Christianna Diane Bowen, LMFT
• Angelica Bretton, CPTA

• Social Worker in Andover, KS
• Providers in Andover, KS by specialty
• Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.