MRS. KELLEY MARIE BOLTIN (NPI# 1083985733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083985733 |
| Entity Type | Individual |
| Full Name | MRS. KELLEY MARIE BOLTIN |
| Credential | M.S. LPC |
| Practice Address |
405 W Boxelder Rd Ste C8 Gillette WY 82718-5320 |
| Mailing Address |
113 S Gillette Ave Ste 242 Gillette WY 82716-3741 |
| Practice Telephone | 3076894185 |
| Practice Fax Number | 3076894185 |
| Mailing Telephone | 3076899090 |
| Mailing Fax Number | 3073634339 |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2020-07-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
1475 | WY | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC 1475 | WY | Behavioral Health & Social Service Providers |
| Street Address |
405 W BOXELDER RD STE C8 |
| City | GILLETTE |
| State | WY |
| Zip Code | 82718-5320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912413964 | Kaylyn Brook Bahnson | Pharmacist | 2000 South Douglas Hwy Walgreens Pharmacy, Gillette, WY 82718 | 2017-12-28 |
| 1205373073 | Cheryl Trembath | Counselor | 201 West Lakeway Rd, Suite 1004, Gillette, WY 82718 | 2017-01-31 |
| 1043769078 | Employment Testing Services | Clinical Medical Laboratory | 3805 South Douglas Hwy, Unit 1, Gillette, WY 82718 | 2016-10-03 |
| 1750730339 | Caritas Mental Health LLC | Community/Behavioral Health | 5204 Raven St, Gillette, WY 82718 | 2016-06-06 |
| 1902298029 | Jena Cowen | Day Training, Developmentally Disabled Services | 5305 Cowen Drive, Gillette, WY 82718 | 2015-02-26 |
| 1720480635 | Brenda Kay Upton | Pharmacist | 2300 S Douglas Highway, Gillette, WY 82718 | 2014-09-23 |
| 1891127825 | Bighorn Dental Clinic PC | Dentist | 4403 Running W. Drive, Gillette, WY 82718 | 2013-08-01 |
| 1750726212 | High Desert Healthcare LLC | Clinic/Center | 1013 East Boxelder Rd, Suite 200, Gillette, WY 82718 | 2013-05-09 |
| 1225224231 | County of Campbell | Public Health or Welfare | 2301 South 4j Rd, Gillette, WY 82718 | 2007-09-24 |
| 1043424336 | Lowell R Amiotte II | Anesthesiology | 3100 W Lakeway Suite 3, Northern Plains Anesthesia Associates, Gillette, WY 82718 | 2007-05-09 |
| Find all providers in zip 82718 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033690656 | Jane R King | Counselor | 400 S Kendrick Ave Ste 104c, Gillette, WY 82716-3848 | 2018-08-22 |
| 1205373073 | Cheryl Trembath | Counselor | 201 West Lakeway Rd, Suite 1004, Gillette, WY 82718 | 2017-01-31 |
| 1366833832 | Antionette Michelle Harris | Counselor | 1001 S Douglas Hwy Ste 110, Gillette, WY 82716-4951 | 2015-02-05 |
| 1912285461 | Melisa J Miller | Counselor | 1901 Energy Ct, Suite 311, Gillette, WY 82718-5522 | 2011-08-02 |
| 1659668416 | Polly Jean Akins | Counselor | 400 S Kendrick Ave Ste 301, Gillette, WY 82716-3803 | 2011-06-30 |
| 1831217579 | Diana Lucile Foster | Counselor | 4607 Alex Way, Gillette, WY 82718-4145 | 2007-03-27 |
| 1689775587 | Michelle Daigle | Counselor | 1401 W 2nd St, Suite #1, Gillette, WY 82716-3333 | 2006-09-26 |
| 1760588875 | Preuit & Daigle Professional Counseling P.C. | Counselor | 1401 W 2nd St Unit 1, Gillette, WY 82716-3334 | 2006-09-15 |
| 1033742622 | Aspire Counseling, LLC | Counselor | 201 W Lakeway Rd Ste 1004, Gillette, WY 82718-6349 | 2020-02-21 |
| 1801429287 | Wyoming Center for Clinical Excellence | Counselor | 2001 W Lakeway Rd Ste D, Gillette, WY 82718-5774 | 2020-02-13 |
| Find all providers in GILLETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.