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CONNOR BOLDUC
NPI 1093460180
Counselor - Professional in Maplewood, MN

Active since February 16, 2022PECOS Enrolled
2103 COUNTY ROAD D E STE B, MAPLEWOOD, MN 55109(612) 915-0049 Get Directions Write a Review

NPPES record last updated: July 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Connor Bolduc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNOR BOLDUC (NPI 1093460180) is an individual professional provider in Maplewood, Minnesota, licensed in Minnesota (4468) and active in the NPI registry since February 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Saint Paul.

NPPES Registry Identity

NPI1093460180
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameCONNOR BOLDUC
Location Address2103 COUNTY ROAD D E STE BMaplewood, MN 55109-5358
Mailing Address4800 N Scottsdale Rd Ste 2500Scottsdale, AZ 85251-7630 · (612) 915-0049
Phone(612) 915-0049
Sole ProprietorNo
Enumeration DateFebruary 16, 2022
Last NPPES UpdateJuly 28, 2025
NPPES CertifiedJuly 28, 2025
✔ NPI 1093460180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MN · 4468
2103 COUNTY ROAD D E STE B, Maplewood, MN 55109
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Secondary Practice Location 1

Location 1239 Cleveland Ave NSaint Paul, MN 55104-5730 · Phone (612) 712-6435

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Connor Bolduc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CYNTHIA BURGESS
Counselor (Mental Health)
2103 COUNTY ROAD D E STE B
MAPLEWOOD, MN 55109
Ramsey County (651) 748-5019
JOEL LAMBRIDES
Counselor (Mental Health)
2103 COUNTY ROAD D E STE B
MAPLEWOOD, MN 55109
Ramsey County (651) 748-5019
TAMARA CATHERIN LUNDBERG
Counselor (Mental Health)
2103 COUNTY ROAD D E STE B
MAPLEWOOD, MN 55109
Ramsey County (651) 748-5019
AMANDA AMOS BA
Student in an Organized Health Care Education/Training Program
2103 COUNTY ROAD D E STE B
MAPLEWOOD, MN 55109
Ramsey County (651) 748-5019
MS. GREER MINETTE GUST LPC
Counselor (Professional)
2103 COUNTY ROAD D E STE B
MAPLEWOOD, MN 55109
Ramsey County (612) 915-0049
EMARY LEE
Counselor (Mental Health)
2103 COUNTY ROAD D E STE B
MAPLEWOOD, MN 55109
Ramsey County (651) 748-5019
KATHERINE FALK
Marriage & Family Therapist
2103 COUNTY ROAD D E STE B
MAPLEWOOD, MN 55109
Ramsey County (612) 924-3807
AUBREY LYNN WORKMAN MA, R-DMT
Counselor (Professional)
2103 COUNTY ROAD D E STE B
MAPLEWOOD, MN 55109
Ramsey County (952) 564-7445

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Connor Bolduc's NPI number?

The NPI number for Connor Bolduc is 1093460180. It was assigned to this individual provider in the NPPES registry on February 16, 2022.

Where is Connor Bolduc located?

Connor Bolduc practices at 2103 County Road D E Ste B, Maplewood, MN 55109. The listed phone number is (612) 915-0049.

What is Connor Bolduc's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Connor Bolduc enrolled in Medicare?

Yes. Connor Bolduc is registered in the Medicare PECOS enrollment system.

What insurance does Connor Bolduc accept?

Health plans from HealthPartners and Sanford Health Plan list Connor Bolduc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Connor Bolduc was last updated on July 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.