Carla Evonne Bouc, LCPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

180013435 Issued in IL

Practice address

812 S Virginia Ave
Belleville, IL 62220-3689

Phone

(618) 236-2482

NPI assigned

Apr 10, 2007

Last updated

Mar 28, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Brighter Families LLC

  • Early Intervention Provider Agency
  • Belleville, IL
  • NPI 1922464510
  NPD Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1801919022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S VIRGINIA AVE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203689",
            "telephone_number": "618-236-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S VIRGINIA AVE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203689",
            "telephone_number": "618-236-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUC",
        "first_name": "CARLA",
        "middle_name": "EVONNE",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180013435",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Boose
• Born to Bloom Pediatric Therapy
• Kaitlyn Boschenreither
• Stephen Boschenreither, CPHT
• Amanda Kay Boscoe
• Kevin Bouse, OT
• Virginia S Bouse, P. T.
• Peyton Bowe, PA-C
• Michael Bower, ATC. LAT.
• Elisha Boyd, FNP

• Counselor in Belleville, IL
• Providers in Belleville, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.