Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Bolton

Individual provider Psychologist · NPI 1164128625

Mark Bolton is a Psychologist in Cape Canaveral, Florida. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2023

Practice location Address checks out

549 Taylor Ave
Cape Canaveral, FL 32920-5204
Phone: (313) 258-4137
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence CC-0C4150341544 (MI)

Record details

NPI number1164128625
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 6, 2023
Last updated in NPPESFebruary 6, 2023
Certification dateFebruary 6, 2023
Mailing address549 Taylor Ave, Cape Canaveral, FL 32920-5204

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