Meagen Boulay, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LMFT109452 Issued in CA

Practice address

11090 De Anza Rd
Victorville, CA 92392-1826

Phone

(760) 533-0442

NPI assigned

Feb 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Meagen Higgins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1932855608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 292353",
            "city": "PHELAN",
            "state": "CA",
            "postal_code": "923292353",
            "telephone_number": "760-533-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11090 DE ANZA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923921826",
            "telephone_number": "760-533-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULAY",
        "first_name": "MEAGEN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LMFT109452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEAGEN",
            "last_name": "HIGGINS",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nichonda Boudreaux
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• Jack Bourklian, DDS
• Ellen Bourne
• Alyssa Bousquet
• Sharyl Bowen, QASP-S

• Mental Health Counselor in Victorville, CA
• Providers in Victorville, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.