Boulevard Counseling PLLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

BOULEVARD COUNSELING PLLC

Practice address

1835 S Hamlin Ave
Chicago, IL 60623-3895

Phone

(419) 595-0667

NPI assigned

Aug 9, 2023

Last updated

Aug 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeanette Lee, LCSW, JDNPI 1851836936

Title

Psychotherapist

Phone

(419) 595-0667

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeanette Lee, L.S.W., J.D.

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1851836936
  NPD Authorized official

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1780367565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 S HAMLIN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233895",
            "telephone_number": "419-595-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 S HAMLIN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233895",
            "telephone_number": "419-595-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "419-595-0667",
        "authorized_official_credential": "LCSW, JD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hamid Bouiri, PHARM.D
• Nikoleta Ninette Boukydis, CLINCAL PSYCHOLOGIST
• Brian Robert Boulay, MD
• Bethany Page Bouldin, MD
• Boulevard Care Center
• Symaya Boulrece
• Linda Georgette Boulware, APRN
• Heather Anne Bouma-Johnston, MD
• Imane Boumaraf, MD
• Redouane Boumendjel, MD

• Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.