CHARLIE ELIZA BOUTILLETTE LPC MA
NPI 1508990086
Counselor - Mental Health in Alamosa, CO
About Charlie Eliza Boutillette Lpc Ma NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHARLIE ELIZA BOUTILLETTE LPC MA (NPI 1508990086) is an individual mental health provider in Alamosa, Colorado, licensed in Colorado (1725) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1995).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Charlie Eliza Boutillette Lpc Ma 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.
Medicare Billing Reassignment
Medicare enrollment records show Charlie Boutillette reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Denver, CO 80202
- Reassigned Medicare billing, Colorado enrollment
- 940 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Charlie Boutillette's NPI number?
The NPI number for Charlie Boutillette is 1508990086. It was assigned to this individual provider in the NPPES registry on March 15, 2007.
Where is Charlie Boutillette located?
Charlie Boutillette practices at 200 Ross Ave, Alamosa, CO 81101. The listed phone number is (719) 589-2786.
What is Charlie Boutillette's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Charlie Boutillette enrolled in Medicare?
Yes. Charlie Boutillette is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Charlie Boutillette's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Charlie Boutillette reassigns Medicare benefits to Sondermind Provider Network LLC (Denver, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Charlie Boutillette's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Charlie Boutillette accept?
Health plans from Oscar Insurance Company and Select Health list Charlie Boutillette as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Charlie Boutillette was last updated on September 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Charlie Eliza Boutillette, LPC MA · NPI 1508990086
Mental Health provider in Alamosa, Colorado. Individual provider, active in the CMS NPPES registry since March 15, 2007.
## Identity
- **NPI:** 1508990086 (Entity type: Individual)
- **Enumerated:** March 15, 2007
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 1725 (Colorado)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 200 ROSS AVE, Alamosa, CO 81101-2451
- **Phone:** (719) 589-2786
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Sondermind Provider Network LLC (NPI 1760854442, Denver, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1995
## Record status
- **NPPES last updated:** September 18, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1508990086) · Data from the CMS NPPES public registry.