Jeremy Adam Bolles, T-LMHC
Counselor, Professional in Johnston, IA. Individual provider (NPI-1).
NPI number1962200477
StatusActive
Last updated in NPPESMar 3, 2025
Details
- NPI
- 1962200477
- Entity type
- Individual (NPI-1)
- Name
- Jeremy Adam Bolles
- Credential
- T-LMHC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 3, 2025
- Certification date
- Mar 3, 2025
- Last updated
- Mar 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 129860 | IA | Yes |
Practice location
5415 Nw 88th St Ste 100Johnston, IA 50131-2951
Phone 515-727-1338
Mailing address
2021 Polk DrAmes, IA 50010-4316
Phone 515-203-1918
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