# BETTY BOLTE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1952342008
- **Gender:** F
- **Credential:** LCP, LCAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 476 | KS | — |
| 103T00000X | Psychologist | 0517 | KS | — |
| 103T00000X | Psychologist | 904 | KS | Yes |

## Other

- **Enumeration date:** 06/09/2006
- **Last updated:** 02/06/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 11658758 | CAQH | — |
| 05 | — | 200440980A | — | KS |
| 01 | — | 856659 | BCBS | KS |