Kenna Christine Bolton Holz, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5425 Issued in MN

Practice address

530 East Second Street
Duluth, MN 55805

Phone

(218) 786-5360

NPI assigned

Dec 8, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health Duluth Hospital, Duluth, MN, CCN 240019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment Care Compare group NPD
• St. Mary'S Hospital of Superior

  • Critical Access Hospital
  • Superior, WI
  • NPI 1083657886
  Medicare reassignment NPD
• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MN
  • NPI 1184132664
  NPD
• The Duluth Clinic, LTD.

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD
• St. Mary'S Hospital of Superior

  • Critical Access Hospital Clinic/Center
  • Superior, WI
  • NPI 1588691588
  NPD
• Deer River Healthcare Center, Inc.

  • Critical Access Hospital
  • Deer River, MN
  • NPI 1225049018
  NPD (past)
• The Duluth Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1245278209
  NPD (past)

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1962770685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E THIRD STREET",
            "address_2": "MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 EAST SECOND STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-5360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 West Superior Street",
            "address_2": "Suite 702",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "55802",
            "country_code": "US",
            "telephone_number": "218-722-4058",
            "fax_number": "218-722-4059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLTON HOLZ",
        "first_name": "KENNA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2918-57",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "5425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bolen Chiropractic, PA
• Troy Christopher Bolen, D.C.
• Kelly Marie Bolf
• John Patrick Bollins
• Amber Bolstad, MT-BC
• Erin Bolton, LICSW
• Robert Paul Boman
• Molly Maren Bonderson, OTR/L
• Lauren Marie Bonin
• Steven Richard Bonin, MD

• Clinical Psychologist in Duluth, MN
• Providers in Duluth, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.