| David Bolton, MED, LPC | |
|
12 N 5th Ave, Wilmington, NC 28401-4537 | |
| (910) 765-1003 | |
| (910) 765-1004 |
| Full Name | David Bolton |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 12 N 5th Ave, Wilmington, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427101617 | NPI | - | NPPES |
| 16497 | Other | NC | BLUE CROSS BLUE SHIELD |
| 6102305 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 906 (North Carolina) | Primary |
| Entity Name | Triad Behavioral Resources Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336292556 PECOS PAC ID: 7911316435 Enrollment ID: O20210512002113 |
| Mailing Address | Practice Location Address |
|---|---|
| David Bolton, MED, LPC 405 Blandwood Ave., Greensboro, NC 27401 Ph: (336) 389-1413 | David Bolton, MED, LPC 12 N 5th Ave, Wilmington, NC 28401-4537 Ph: (910) 765-1003 |
Mrs. Makeba Sharice Shaw, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 221 Elisha Dr, Wilmington, NC 28405 Phone: 910-233-0355 Fax: 910-799-6263 | |
Mrs. Holly Cunningham, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3963 Market St, Suite A, Wilmington, NC 28403 Phone: 910-362-9474 Fax: 910-362-9192 | |
Kelly Nicole French, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 313 Walnut St Ste 101, Wilmington, NC 28401 Phone: 828-214-7870 | |
Erin Mace, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2425 S 17th St, Wilmington, NC 28401 Phone: 910-313-3232 | |
Kristin Hoffman, MA, LCAS, LCMHC-A Counselor Medicare: Not Enrolled in Medicare Practice Location: 705 Wooster St, Wilmington, NC 28401 Phone: 910-386-7378 | |
Kelly Kristine Rose, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1619 Grace St, Wilmington, NC 28401 Phone: 919-896-0214 | |
Emily Kohls, LCMHC, LCAS Counselor Medicare: Not Enrolled in Medicare Practice Location: 700 Military Cutoff Rd Ste 108b, Wilmington, NC 28405 Phone: 910-218-1603 Fax: 910-889-0736 |