Sarah L Boulac, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39003518A Issued in IN

Practice address

615 N 18TH St Ste 101
Lafayette, IN 47904-3413

Phone

(765) 423-5361

Fax

(765) 447-8411

NPI assigned

Jul 17, 2009

Last updated

May 10, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Willowstone Family Services

  • Mental Health Counselor
  • Lafayette, IN
  • NPI 1780742874
  NPD (past)

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1689804114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N 18TH ST STE 101",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043413",
            "telephone_number": "765-423-5361",
            "fax_number": "765-447-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N 18TH ST STE 101",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043413",
            "telephone_number": "765-423-5361",
            "fax_number": "765-447-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULAC",
        "first_name": "SARAH",
        "middle_name": "L",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003518A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Heine Bos, MD, PHD
• Roger Bosley, M.D.
• Emily G Bosso
• Anna Bostian, MS CCC-SLP
• Mallory Bottorff
• Claire Bour, OTR
• Jarred Bowden, PHARMD
• Corbin Bower
• Kelsey Bower, OTA
• David Alan Bowman, D.C

• Mental Health Counselor in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.