LISA BOLMAN (NPI# 1457903031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457903031 |
| Entity Type | Individual |
| Full Name | LISA BOLMAN |
| Credential | PCMHT |
| Practice Address |
1600 Broad Ave Gulfport MS 39501-3603 |
| Practice Telephone | 2288631132 |
| Mailing Telephone | 2288631132 |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-07-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
4143 | MS | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083196463 | Lisa M Bolman | Occupational Therapist | 2529 Detroit Ave, Cleveland, OH 44113-2701 | 2018-09-03 |
| Street Address |
1600 BROAD AVE |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-3603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417934175 | Gulf Coast Mental Health Center | Psychologist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2005-12-23 |
| 1043811839 | Kathy Ulland | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-11-06 |
| 1508463357 | Nicole Brown | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-10-05 |
| 1407453376 | Brian Weber | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-10-05 |
| 1457958639 | Krysten Vagedes | Registered Nurse | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-10-01 |
| 1184239436 | Yeinil Guzman | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-09-14 |
| 1972117216 | Nicole Hymel | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-09-03 |
| 1053921668 | Dana Alexis Mixon | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-08-07 |
| 1801405964 | Elizabeth Moran | Peer Specialist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-07-24 |
| 1013526177 | June Boudreaux | Peer Specialist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582418 | Monica Jean Davis | Counselor | 1601 49th St S, Gulfport, FL 33707-4340 | 2020-09-09 |
| 1396380234 | Jasmine L. Smith | Counselor | 1520 29th Ave Ste 3, Gulfport, MS 39501-2843 | 2019-11-14 |
| 1437710605 | Bridgette Denise Harris | Counselor | 12450 Three Rivers Rd # A-13, Gulfport, MS 39503-2970 | 2019-06-27 |
| 1174010292 | Charla Ann Wilson | Counselor | 2352 E Pass Rd, Gulfport, MS 39507-3805 | 2018-04-13 |
| 1851808893 | Cori L Walker | Counselor | 3427 Washington Ave, Gulfport, MS 39507-3039 | 2017-12-29 |
| 1467964270 | Melissa Lee Georgopolis | Counselor | 5800 20th Ave S, Gulfport, FL 33707-4050 | 2017-11-02 |
| 1376928697 | Holly Arnoult | Counselor | 240b Courthouse Rd, Gulfport, MS 39507-1214 | 2015-07-28 |
| 1942696596 | Debra Steinfeld | Counselor | 1608 53rd St S, Gulfport, FL 33707-4237 | 2015-04-10 |
| 1538500350 | Jaime Kathryn Parker | Counselor | 370 Courthouse Rd Ste 102, Gulfport, MS 39507-1889 | 2013-07-09 |
| 1215279047 | Estelle Lacoste Robinson | Counselor | 1455 E Pass Rd, B, Gulfport, MS 39507-3523 | 2013-03-19 |
| Find all providers in GULFPORT | ||||
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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.