Provider Demographics
NPI:1083840987
Name:BOLICK, INGRID P (P-LMFT)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:P
Last Name:BOLICK
Suffix:
Gender:F
Credentials:P-LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 759194
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-9194
Mailing Address - Country:US
Mailing Address - Phone:828-225-3100
Mailing Address - Fax:828-225-3604
Practice Address - Street 1:53 S FRENCH BROAD AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3272
Practice Address - Country:US
Practice Address - Phone:828-225-3100
Practice Address - Fax:828-225-3604
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP-LMFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist