Individual
DAVID BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED., LPC
Contact information
Practice address
12 N 5TH AVE, WILMINGTON, NC 28401-4537
(910) 765-1003
(910) 765-1004
Mailing address
405 BLANDWOOD AVE., GREENSBORO, NC 27401
(336) 389-1413
(336) 389-1416
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
906
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16497
BLUE CROSS BLUE SHIELD
NC
05
—
6102305
—
NC
Enumeration date
01/19/2007
Last updated
08/24/2023
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