JENNIFER BOLAR JOHNSON – Mental Health Counselor, NPI 1104521830

JENNIFER BOLAR JOHNSON is a healthcare provider. based in Daphne, Alabama. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. ALC04448 (AL). The NPI Number for JENNIFER BOLAR JOHNSON is 1104521830

Main info

Female
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER BOLAR JOHNSON
NPI
1104521830
Phone
(251) 615-1233
Address
28851 N MAIN ST
Enumeration Date
3 April 2023
Last Update Date
3 April 2023

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Secondary Phone
2514733410
Graduation Year
2004 (22 years ago)
PAC ID
6305368507
Group Practice PAC ID
8325437858
Professional Enrollment ID
I20250318000309
Address ID
AL366063000MO1340XDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

390 MENTAL HEALTH COUNSELOR in AL

Provider Addresses for JENNIFER BOLAR JOHNSON

  • 28851 N MAIN ST

    DAPHNE, AL 365267273

    Phone: (251) 615-1233

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250318000309IMental Health CounselorALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36526)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8325437858View full group profile
NameSpecialtyState
Mental Health CounselorAL
Mental Health CounselorAL
Mental Health CounselorAL
Mental Health CounselorAL
Marriage And Family TherapistAL
Clinical PsychologistAL
Mental Health CounselorAL
Mental Health CounselorAL
Mental Health CounselorAL
Mental Health CounselorAL

Reviews

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Frequently asked questions

How do I look up JENNIFER BOLAR JOHNSON by NPI?
Use NPI 1104521830 when you need to reference JENNIFER BOLAR JOHNSON in forms, claims, or directories.
Does this profile mean JENNIFER BOLAR JOHNSON is currently active?
Yes — JENNIFER BOLAR JOHNSON appears active in the national provider directory.
Can you summarize JENNIFER BOLAR JOHNSON's specialty in plain language?
Clinically, the directory lists JENNIFER BOLAR JOHNSON with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What location shows for JENNIFER BOLAR JOHNSON?
We surface Daphne, Alabama for JENNIFER BOLAR JOHNSON based on available NPPES addresses.
How can I contact JENNIFER BOLAR JOHNSON?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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