Provider Demographics
NPI:1174643142
Name:BOLTON COUNSELING & CONSULTING, LLC
Entity Type:Organization
Organization Name:BOLTON COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:EVETTE
Authorized Official - Last Name:BOLTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:803-252-7952
Mailing Address - Street 1:5000 THURMOND MALL
Mailing Address - Street 2:SUITE 309
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2372
Mailing Address - Country:US
Mailing Address - Phone:803-252-7952
Mailing Address - Fax:803-252-7953
Practice Address - Street 1:5000 THURMOND MALL
Practice Address - Street 2:SUITE 309
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2372
Practice Address - Country:US
Practice Address - Phone:803-252-7952
Practice Address - Fax:803-252-7953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4603101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty