JEAN NICHOLAS BOULET (NPI# 1114179108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114179108 |
| Entity Type | Individual |
| Full Name | JEAN NICHOLAS BOULET |
| Other Name | NICK BOULET |
| Credential | LCSW |
| Practice Address |
725 N Highland Ave Suite 100 Winston Salem NC 27101-4180 |
| Mailing Address |
284 Executive Park Dr Ste 100 Concord NC 28025-1833 |
| Practice Telephone | 3366078523 |
| Practice Fax Number | 3367271734 |
| Mailing Telephone | (704) 939-1100 |
| Mailing Fax Number | 7049391173 |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2017-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
C008297 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | UBH | 1114179108 | 01 |
| NC | 1114179108 | 05 | |
| NC | HUMANA | 1114179108 | 01 |
| NC | BCBS | 18859 | 01 |
| NC | 601112-311 | MAGELLAN | 01 |
| Street Address |
725 N HIGHLAND AVE SUITE 100 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27101-4180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639222516 | Triumph LLC | Counselor | 725 N Highland Ave, 2nd Floor, Winston Salem, NC 27101-4206 | 2007-01-22 |
| 1063961084 | Lakisha Patrice Boykin | Counselor | 725 N Highland Ave, Unit 100, Winston Salem, NC 27101-4180 | 2016-10-03 |
| 1922358050 | Catherine Anderson | Counselor | 725 N Highland Ave, Winston Salem, NC 27101-4206 | 2012-09-17 |
| 1770639791 | Triumph LLC | Community/Behavioral Health | 725 N Highland Ave, 2nd Floor, Winston Salem, NC 27101-4206 | 2007-01-25 |
| 1780730895 | Triumph LLC | Psychiatry & Neurology | 725 N Highland Ave, 2nd Floor, Winston Salem, NC 27101-4206 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421876 | Annie Carolina Mccollum | Occupational Therapist | 3 S Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2020-09-09 |
| 1891321337 | Philippe Ayres | Personal Emergency Response Attendant | 475 Vine St., Bowman Gray Center for Medical Education, Winston-salem, NC 27101 | 2020-03-17 |
| 1497385595 | Aereil Moore | Counselor | 655 West 4th St, Winston Salem, NC 27101 | 2020-01-17 |
| 1619519428 | Brandi Melissa Decriscio | Nurse Practitioner | 1200 N Martin Luther King Jr Drive, Winston-salem, NC 27101 | 2019-10-14 |
| 1316502909 | Burke Street Chiropractic, Pllc | Chiropractor | 1016 Burke St., Winston-salem, NC 27101 | 2019-05-08 |
| 1790349728 | Nakia Carter | Counselor | 1o1o W. Northwest Boulevard, Winston-salem, NC 27101 | 2019-04-25 |
| 1003391251 | Hannah Fortwengler Rainey | Nurse Anesthetist, Certified Registered | Medical Center Blvrd, Winston-salem, NC 27101 | 2018-10-03 |
| 1750875928 | Susan Wilhelm Patterson | Nurse Practitioner | 1200 Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2018-06-20 |
| 1194228049 | Anjanette Gilley Benjamin | Counselor | 650 Highland Ave Ste 1000, Winston Salem, NC 27101 | 2018-03-16 |
| 1376054627 | Paulisha Da-shawna Mcintyre | Social Worker | 650 Highland Ave Ste 101, Winston Salem, NC 27101 | 2017-10-13 |
| Find all providers in zip 27101 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884362 | Ranesha Denae Boyd | Social Worker | 2270 Naomi Dr, Winston Salem, NC 27107-4602 | 2020-09-01 |
| 1326665563 | Kristy Dobbins | Social Worker | 3240 Trenchard Ln, Winston Salem, NC 27127-5927 | 2020-07-04 |
| 1033731781 | Robert D Worley | Social Worker | 480 Virginia Newell Ln, Winston Salem, NC 27101-4575 | 2020-05-15 |
| 1659900793 | Peaty Counseling and Consulting, Pllc | Social Worker | 1250 Foxhall Dr, Winston Salem, NC 27106-4436 | 2020-04-01 |
| 1407482862 | Jaime Wright | Social Worker | 3000 Bethesda Pl Ste 801, Winston Salem, NC 27103-3330 | 2020-03-18 |
| 1043778210 | Bernice Cook | Social Worker | 2223 Greenway Ave, Winston Salem, NC 27105-5120 | 2019-03-06 |
| 1285103812 | Kimberley Renee Hunt | Social Worker | 4711 Seminole Ct, Winston Salem, NC 27127-9432 | 2018-11-13 |
| 1619459864 | Shadae T Williams | Social Worker | 1224 Collegian Ter, Winston Salem, NC 27106-6340 | 2018-09-04 |
| 1104321017 | Melanie Carol Mccarthy | Social Worker | 1202 Miller St, Winston Salem, NC 27103-4445 | 2018-03-25 |
| 1417459371 | Awakenings Counseling | Social Worker | 770 Highland Oaks Dr # 100, Winston Salem, NC 27103-7105 | 2018-03-06 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27101 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.