Individual
THOMAS S BOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, CSAC
Contact information
Practice address
3207 LAURA LN STE 100, MIDDLETON, WI 53562-1428
(608) 290-0956
Mailing address
3207 LAURA LN STE 120, MIDDLETON, WI 53562-1428
(608) 752-2930
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15382-132
WI
101YM0800X
Mental Health Counselor
8420-123
WI
1041C0700X
Clinical Social Worker
Primary
8420-123
WI
Other
Enumeration date
04/26/2007
Last updated
03/28/2025
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