Jean Guillaume Nicolas Boulet, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008297 Issued in NC

Practice address

2709 Pinedale Rd Ste B
Greensboro, NC 27408-2018

Phone

(336) 223-5521

Fax

(336) 288-3177

NPI assigned

Oct 21, 2008

Last updated

Apr 30, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Nick Boulet Professional name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Daymark Recovery Services, Inc.

  • Multi-Specialty Clinic/Center
  • Concord, NC
  • NPI 1558329243

  Clinical

  Medicare reassignment NPD
• The Open Heart Therapist PLLC

  • Adult Mental Health Clinic/Center
  • Greensboro, NC
  • NPI 1407749385
  NPD Authorized official
• Daymark Recovery Servcies Inc

  • Community/Behavioral Health Agency
  • Winston Salem, NC
  • NPI 1790807535

  Clinical

  NPD (past)
• Wellmood PLLC

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1154182368
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1114179108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 PINEDALE RD STE B",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274082018",
            "telephone_number": "336-223-5521",
            "fax_number": "336-288-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 PINEDALE RD STE B",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274082018",
            "telephone_number": "336-223-5521",
            "fax_number": "336-288-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULET",
        "first_name": "JEAN",
        "middle_name": "GUILLAUME NICOLAS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "18859",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1114179108",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "1114179108",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "601112-311",
            "identifier": "MAGELLAN",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICK",
            "last_name": "BOULET",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Elizabeth Kathleen Boswell
• Heather Bosworth
• Ernesto Miguel Botero, MD
• Madison Nation Botts, MD
• Edward John Boudreau, D.C
• Marierose Malek Boulos, DDS
• David Edward Bouska, M.D.
• Sean Patrick Bouthilette, DPT
• Anne Rose Boutin-Galipeau, RN
• Jody Bovard-Stuckert, M.D.

• Clinical Social Worker in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.