Active NPI
Natalie Waller Bouffard-Lewis, M.S., LPC
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1063960607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 73051
- Practice address
- 6100 Western PL
Ste 408
Fort Worth, TX 76107-4600 - Phone
- (469) 223-2427
- NPI assigned
- Sep 12, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 73051 | TX | Primary |
Addresses
Primary practice location
6100 Western PL
Ste 408
Fort Worth, TX 76107-4600
Mailing address
4224 SW Loop 820
Fort Worth, TX 76109-5350
Phone (469) 223-2427
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73051 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475712000000",
"number": "1063960607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4224 SW LOOP 820",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761095350",
"telephone_number": "469-223-2427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6100 WESTERN PL",
"address_2": "STE 408",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761074600",
"telephone_number": "469-223-2427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUFFARD-LEWIS",
"first_name": "NATALIE",
"middle_name": "WALLER",
"credential": "M.S., LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-12",
"last_updated": "2016-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "73051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.