Provider Demographics
NPI:1437391679
Name:BOLTE, KAREN LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNN
Last Name:BOLTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10643 KILLARNEY DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-9299
Mailing Address - Country:US
Mailing Address - Phone:859-384-4040
Mailing Address - Fax:
Practice Address - Street 1:10643 KILLARNEY DR
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-9299
Practice Address - Country:US
Practice Address - Phone:859-750-3775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDKY 3326101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY$$$$$$$$$Medicaid
$$$$$$$$$Medicare PIN