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Individual
JESSICA F BOULANGER
Active
Individual
JESSICA F BOULANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LPC, NCC, CCTP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
67194
TX
101YP2500X
Professional Counselor
Primary
67194
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12788486
CAQH NATIONAL PROVIDER DATABASE
—
01
—
226826
NATIONAL CERTIFIED COUNSELOR (NCC) - NATIONAL BOARD OF CERTIFIED COUNSELORS NBCC
—
01
—
526802
AVAILITY -NATIONAL PROVIDER WORKFLOW SOLUTIONS FOR PAYORS
TX
01
—
67194
LICENSED PROFESSIONAL COUNSELOR (LPC) - BEHAVIORAL HEALTH EXECUTIVE COUNSEL BHEC
TX
01
—
998642
CERTIFIED CLINICAL TRAUMA PROFESSIONAL (CCTP) - EVERGREEN CERTIFICATIONS
TX
Enumeration date
11/18/2014
Last updated
04/28/2025
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