MEDICARE: HOLLY BOULANGER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	LPC.0016925	CO

General Provider Information

NPI Number	:	1467095083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY BOULANGER LPC

Provider Business Mailing Address
First Line	:	1355 S COLORADO BLVD STE 502
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1355 S COLORADO BLVD STE 502
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3322
Country	:	US
Telephone Number	:	303-335-0183
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2019
Last Update Date	:	05/11/2026

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Directions to “ HOLLY BOULANGER LPC” Practice Location

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