Active NPI
Lauren Boulet, SLP
- Speech-Language Pathologist
- Oswego, NY
National Provider Identifier
1871993188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 024111
- Practice address
- 110 W 6TH St
Oswego, NY 13126-2507 - Phone
- (315) 349-5558
- Fax
- (315) 349-5652
- NPI assigned
- Aug 25, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 024111 | NY | Primary |
Addresses
Primary practice location
110 W 6TH St
Oswego, NY 13126-2507
Mailing address
110 W 6TH St
Oswego, NY 13126-2507
Phone (315) 349-5558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024111 | NY | MD | Clinical Psychologist |
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.
-
- Developmental Disabilities Clinic/Center
- Staten Island, NY
- NPI 1750469912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408924800000",
"number": "1871993188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 W 6TH ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131262507",
"telephone_number": "315-349-5558",
"fax_number": "315-349-5652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 W 6TH ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131262507",
"telephone_number": "315-349-5558",
"fax_number": "315-349-5652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOULET",
"first_name": "LAUREN",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-25",
"last_updated": "2014-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "024111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.