Active NPI
Lilia Boutaleb
- Counselor
- Allston, MA
National Provider Identifier
1770090565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 14 Fordham Rd
Allston, MA 02134-3000 - Phone
- (617) 782-6460
- NPI assigned
- Jan 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary | ||
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
14 Fordham Rd
Allston, MA 02134-3000
Mailing address
14 Fordham Rd
Allston, MA 02134-3000
Other practice location 1
13950 Milton Ave Ste 200B
Westminster, CA 92683-2939
Phone (855) 832-6727
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Youth Services | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adolescent and Children Mental Health Clinic/Center
- Mission Viejo, CA
- NPI 1790817468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1770090565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 FORDHAM RD",
"city": "ALLSTON",
"state": "MA",
"postal_code": "021343000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 FORDHAM RD",
"city": "ALLSTON",
"state": "MA",
"postal_code": "021343000",
"telephone_number": "617-782-6460"
}
],
"practiceLocations": [
{
"address_1": "13950 Milton Ave Ste 200B",
"address_purpose": "LOCATION",
"city": "Westminster",
"state": "CA",
"postal_code": "926832939",
"country_code": "US",
"telephone_number": "855-832-6727",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOUTALEB",
"first_name": "LILIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-03",
"last_updated": "2022-06-06",
"certification_date": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.