The Open Heart Therapist PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

THE OPEN HEART THERAPIST PLLC

Practice address

2709 Pinedale Rd Ste B
Greensboro, NC 27408-2018

Phone

(336) 223-5521

Fax

(336) 288-3177

NPI assigned

May 30, 2025

Organization subpart

No

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

Authorized official

Name

Jean G N Boulet, LCSWNPI 1114179108

Title

Owner

Phone

(336) 223-5521

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jean Guillaume Nicolas Boulet, LCSW

  • Clinical Social Worker
  • Greensboro, NC
  • NPI 1114179108
  NPD Authorized official

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

{
    "created_epoch": "1748563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1407749385",
    "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": {
        "organization_name": "THE OPEN HEART THERAPIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "BOULET",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "G N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-223-5521",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Moses H. Cone Memorial Hospital Operating Corporation
• The Moses H. Cone Memorial Hospital Operating Corporation
• The Moses H. Cone Memorial Hospital Operating Corporation
• The Oil Group
• The Open Door Program
• The Optical Place, Inc.
• The Partee Group, LLC
• The Patton Practice
• The Perfect Voice
• The Phonetic Block, PLLC

• Adult Mental Health Clinic/Center in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Adult Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.