Jessica F Boulanger, MED, LPC, NCC, CCTP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

67194 Issued in TX

Practice address

4414 Centerview Ste 204
San Antonio, TX 78228-1432

Phone

(210) 739-4200

Fax

(210) 757-3220

NPI assigned

Nov 18, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1831595818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 CENTERVIEW STE 204",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281432",
            "telephone_number": "210-739-4200",
            "fax_number": "210-757-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 CENTERVIEW STE 204",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281432",
            "telephone_number": "210-739-4200",
            "fax_number": "210-757-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULANGER",
        "first_name": "JESSICA",
        "middle_name": "F",
        "credential": "MED, LPC, NCC, CCTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "67194",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFIED COUNSELOR (NCC) - NATIONAL BOARD OF CERTIFIED COUNSELORS NBCC",
            "identifier": "226826",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVAILITY  -NATIONAL PROVIDER WORKFLOW SOLUTIONS FOR PAYORS",
            "identifier": "526802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED CLINICAL TRAUMA PROFESSIONAL (CCTP) - EVERGREEN CERTIFICATIONS",
            "identifier": "998642",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR (LPC) - BEHAVIORAL HEALTH EXECUTIVE COUNSEL BHEC",
            "identifier": "67194",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NATIONAL PROVIDER DATABASE",
            "identifier": "12788486",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Klayme-Shane Boucher, DO
• Carlos Mario Bouchot, MD
• Carmen Boudreau, LBSW
• Christian Martin Boudreaux, PA-C
• Rebecca Diane Boudreaux, PHARMD
• Hayley Bouldin, RBT
• Joelle M Bouldoukian-Choucair, O.D.
• Karen Emad Boules
• Toni Bouley, LMSW
• Amanda W Boullard

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

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