# LARRY ARNOLD BOLDMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1326634924
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | LCDCII.161861 | OH | Yes |
| 101YM0800X | Mental Health Counselor | QMHS.MASTERS | OH | — |
| 175T00000X | Peer Specialist | APS.002206 | OH | — |

## Other

- **Enumeration date:** 12/17/2020
- **Last updated:** 05/10/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0441111 | — | OH |