Clarence George Bolda Jr., MS, LLMFT
Individual provider Active NPI Marriage & Family Therapist · Flint, MI
NPI 1891937447 · NPPES record last updated Mar 28, 2009
Key facts
- NPI
- 1891937447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- L1469109 (MI)
- Practice address
- 901 Chippewa St
Flint, MI 48503-1570 - Phone
- (810) 232-9950
- NPI assigned
- Mar 28, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1469109 | MI | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | L1469109 | MI | Yes |
Addresses
Primary practice location
901 Chippewa St
Flint, MI 48503-1570
Mailing address
5361 Sequoia CT
Grand Blanc, MI 48439-3502
Phone (810) 742-4341
Other providers in Flint, MI
- Paul A Bohms
- Lyndsey Renee Bohnard
- Boike Medical Services PLLC
- David Alan Boike
- Rebecca Sue Boisclair
- Cynthia Bolden-Howard
- Cassandra Bolden
- Stephanie Nicole Boldt
- Ashley L Boltjes
- Michael Dwayne Bolton
All providers in Flint, MI · Marriage & Family Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.