DR. BRIAN KEITH BOLEN PSY. D. L.M.H.C. NPI 1356677421

NPI Information

  • NPI: 1356677421
  • Provider Name: DR. BRIAN KEITH BOLEN, PSY. D., L.M.H.C.
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3903 NORTHDALE BLVD STE 100-47
    TAMPA, FL
    ZIP 33624
  • Phone: (813) 817-8498

Map and Directions

Get Directions

NPI Details

DR. Brian Keith Bolen, PSY. D., L.M.H.C. is a mental health counselor in Tampa, FL. DR. Brian Keith Bolen, PSY. D., L.M.H.C. NPI is 1356677421. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3903 NORTHDALE BLVD STE 100-47
TAMPA, FL
ZIP 33624-864
Phone: (813) 817-8498
Fax: (813) 406-5158

The NPI 1356677421 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/26/2009 and was last updated on 11/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthMH8545FLORIDANo
2101YA0400XCounselorAddiction (Substance Use Disorder)CAP 2482FLORIDANo
3101YM0800XCounselorMental HealthNo
4101YM0800XCounselorMental HealthMH 8545FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.