Provider Demographics
NPI:1598311680
Name:BOLGER PSYCHOTHERAPY & ASSESSMENTS, LLC
Entity Type:Organization
Organization Name:BOLGER PSYCHOTHERAPY & ASSESSMENTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OF LLC
Authorized Official - Prefix:
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:401-218-8630
Mailing Address - Street 1:191 SOWAMS RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-4607
Mailing Address - Country:US
Mailing Address - Phone:401-218-8630
Mailing Address - Fax:401-441-6529
Practice Address - Street 1:191 SOWAMS RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:RI
Practice Address - Zip Code:02806-4607
Practice Address - Country:US
Practice Address - Phone:401-218-8630
Practice Address - Fax:401-441-6529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty