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

Mary Maiio Bolgan

Individual provider Clinical Social Worker · NPI 1699484410

Mary Maiio Bolgan is a Clinical Social Worker in Louisville, Kentucky. Qualified in 2022, 4 years ago. Accepts Medicare assignment. Licensed in Kentucky and North Carolina.

Years since qualifying
4
Licensed in
KY, NC
In the registry since
2022
Specialties on file
3
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Practice location Address checks out

6801 Dixie Hwy Ste 132
Louisville, KY 40258-3952
Phone: (502) 657-2701
Fax: (502) 536-7991
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCS00001464 (KY)
Clinical Social Worker Taxonomy 1041C0700X · Licence P018195 (NC)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence LCAS-28380 (NC)

Record details

NPI number1699484410
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 21, 2022
Last updated in NPPESMay 18, 2026
Certification dateMay 18, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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