Boulter, Jay L

Boulter, Jay L is an individual health care provider with primary practice located at 203 Cedarwood Dr , Salisbury NC 28147-9111. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Boulter, Jay L can be contacted via phone (704) 633-3117.

Contact Information

Primary practice address
203 Cedarwood Dr Salisbury NC 28147-9111
Phone: (704) 633-3117
Fax: (704) 633-3117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2335 North Carolina
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 489 North Carolina
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MFC 19316 California

Profile Details

NPI number 1447210836
LBN Legal business name Boulter, Jay L
Credentials LMFT, LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447210836 NPPES
North Carolina Other 34918 CIGNA BEHAVIORAL PIN
North Carolina Other 1010U CIGNA BEHAVIORAL PIN
North Carolina Other 5746163 CIGNA BEHAVIORAL PIN
North Carolina Other 118421 CIGNA BEHAVIORAL PIN
North Carolina MEDICAID 1584 CIGNA BEHAVIORAL PIN

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