Provider Demographics
NPI:1255061503
Name:BOLLING, KRISHNA (LMSW)
Entity type:Individual
Prefix:
First Name:KRISHNA
Middle Name:
Last Name:BOLLING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 RAVENWOODS DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-2754
Mailing Address - Country:US
Mailing Address - Phone:757-286-2224
Mailing Address - Fax:
Practice Address - Street 1:636 RAVENWOODS DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-2754
Practice Address - Country:US
Practice Address - Phone:757-286-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0903003041104100000X
VA0906011605104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker