MR. BRADLEY RAY BOLIN BS
NPI 1104127141
Counselor in Broken Arrow, OK

Q: What is Bradley Bolin's NPI number?

The NPI number for Bradley Bolin is 1104127141. It was assigned to this individual provider in the NPPES registry on November 8, 2010.

Q: What is Bradley Bolin's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Bolin was last updated on November 8, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years 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.

Active since November 08, 2010

3100 S ELM PL STE B, BROKEN ARROW, OK 74012(918) 286-2535(918) 286-7693 Get Directions Write a Review

NPPES record last updated: November 8, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Bradley Ray Bolin Bs NPPES

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

MR. BRADLEY RAY BOLIN BS (NPI 1104127141) is an individual counselor in Broken Arrow, Oklahoma and active in the NPI registry since November 2010.

NPPES Registry Identity

NPI1104127141

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameMR. BRADLEY RAY BOLINCredential: BS

Location Address3100 S ELM PL STE BBroken Arrow, OK 74012-7950

Mailing Address3100 S Elm Pl Ste BBroken Arrow, OK 74012-7950 · (918) 286-2535 · Fax (918) 286-7693

Phone(918) 286-2535

Fax(918) 286-7693

Sole ProprietorYes

Enumeration DateNovember 8, 2010

✔ NPI 1104127141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

3100 S ELM PL STE B, Broken Arrow, OK 74012

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Other Providers at the Same Location NPPES 9

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

MRS. REGINA LYNNE CARRELS BS, PSRS

Counselor (Mental Health)