NPIMap

Individual provider Active NPI

Jonathan M Boudin, M.ED., LMHCA

  • Mental Health Counselor
  • Bellingham, WA
National Provider Identifier
1912371980
Registry record updated Nov 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC60601851 Issued in WA
Practice address
1329 Lincoln St
Suite 2
Bellingham, WA 98229-6279
Phone
(604) 788-1710
Fax
(360) 647-6719
NPI assigned
Nov 13, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC60601851 WA Primary

Addresses

Primary practice location

1329 Lincoln St
Suite 2
Bellingham, WA 98229-6279

Mailing address

1329 Lincoln St
Suite 2
Bellingham, WA 98229-6279
Phone (604) 788-1710

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
MC60601851WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lea Lin, LMHC PLLC Past Accepting new patients
Pamela Fuller, Ma, Psychotherapist, PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447372800000",
    "number": "1912371980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 LINCOLN ST",
            "address_2": "SUITE 2",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982296279",
            "telephone_number": "604-788-1710",
            "fax_number": "360-647-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 LINCOLN ST",
            "address_2": "SUITE 2",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982296279",
            "telephone_number": "604-788-1710",
            "fax_number": "360-647-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDIN",
        "first_name": "JONATHAN",
        "middle_name": "M",
        "credential": "M.ED., LMHCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-13",
        "last_updated": "2015-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60601851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; 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.