Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charlie Eliza Boutillette, LPC, MA

Individual provider Mental Health Counselor · NPI 1508990086

Charlie Eliza Boutillette, LPC, MA is a Mental Health Counselor in Alamosa, Colorado. Qualified in 1995, 31 years ago. Practices with Sondermind Provider Network LLC, a 1,258-clinician group and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
31
Licensed in
CO
In the registry since
2007
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.
MA — Master of Arts
A graduate arts degree.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

200 Ross Ave
Alamosa, CO 81101-2451
Phone: (719) 589-2786
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 1725 (CO)

Record details

NPI number1508990086
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC , MA
Sole proprietorYes
NPI enumeratedMarch 15, 2007
Last updated in NPPESSeptember 18, 2024
Certification dateSeptember 18, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Sondermind Provider Network Llc — 1258 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Alamosa