Individual provider Active NPI

Betty Jean Bollenbacher, LSW

  • Social Worker
  • Columbus, OH
National Provider Identifier
1891387627
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2105777 Issued in OH
Practice address
195 N Grant Ave Ste 250
Columbus, OH 43215-2855
Phone
(888) 522-9174
NPI assigned
Feb 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2105777 OH Primary

Addresses

Primary practice location

195 N Grant Ave Ste 250
Columbus, OH 43215-2855

Mailing address

195 N Grant Ave Ste 250
Columbus, OH 43215-2855

Other identifiers 1

IdentifierTypeStateIssuer
2910854MedicaidOH

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
2105777OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1891387627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 N GRANT AVE STE 250",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 N GRANT AVE STE 250",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152855",
            "telephone_number": "888-522-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLENBACHER",
        "first_name": "BETTY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "2105777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.