KELLIE BOULDIN LPC
NPI 1124482328
Counselor - Professional in Cheyenne, WY

Q: What is Kellie Bouldin's NPI number?

The NPI number for Kellie Bouldin is 1124482328. It was assigned to this individual provider in the NPPES registry on April 13, 2016.

Q: What is Kellie Bouldin's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Kellie Bouldin was last updated on October 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 13, 2016PECOS EnrolledAccepts Medicare Assignment

2617 E LINCOLNWAY STE G, CHEYENNE, WY 82001(307) 514-1288(307) 514-0979 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 9, 2024, May 16, 2018, Jun 19, 2017 (3 updates tracked since 2017).

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About Kellie Bouldin Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLIE BOULDIN LPC (NPI 1124482328) is an individual professional provider in Cheyenne, Wyoming, licensed in Wyoming (LPC-1727) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1124482328

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameKELLIE BOULDINCredential: LPC

Location Address2617 E LINCOLNWAY STE GCheyenne, WY 82001-5671

Mailing Address2617 E Lincolnway Ste GCheyenne, WY 82001-5671 · (307) 514-1288

Phone(307) 514-1288

Fax(307) 514-0979

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateApril 13, 2016

Last NPPES UpdateOctober 9, 20243 updates tracked since enumeration

NPPES CertifiedOctober 9, 2024

✔ NPI 1124482328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in WY · LPC-1727

Also ListedCounselorTaxonomy 101Y00000X

2617 E LINCOLNWAY STE G, Cheyenne, WY 82001

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kellie Bouldin Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133565351

PECOS Enrollment IDI20240311002237

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE ANN MCMACKIN MSW, LCSW

Social Worker (Clinical)