Jaclyn Ruth Bolen, LICSW
NPI 1982371860ActiveIndividual· Social Worker· Shady Spring, WV
Social Worker (LICSW) in Shady Spring, West Virginia, licensed in WV, with an NPI issued in August 2021. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1982371860 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | Yes |
| NPI issued | Aug 27, 2021 |
| Last updated in NPPES | Jul 8, 2026 |
| Certified by provider | Jul 8, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | DP00946319 | WV |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (WV) |
|---|