NPI 1700279601 · live from the CMS NPI Registry
Jeffrey Tyler Bolin, MS, BCBA, LBA
Behavior Analyst in Louisville, KY. National Provider Identifier 1700279601, active.
NPI record
| NPI | 1700279601 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 7902 Beulah Church Rd Unit 103, Louisville, KY 40228 |
| Practice phone | 023-788-3115 |
| Mailing address | 1074 Meade Springs Rd, Brandenburg, KY 40108 |
| Enumerated | March 17, 2015 |
| Last updated | July 2, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 163604 (KY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.