ROBERT JOHN BOULEY (MA, LPCC) – Counselor, NPI 1831532159

ROBERT JOHN BOULEY (MA, LPCC) is a healthcare provider. based in Apple valley, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, LPCC. They hold a License No. CC00576 (MN). The NPI Number for ROBERT JOHN BOULEY (MA, LPCC) is 1831532159

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
ROBERT JOHN BOULEY (MA, LPCC)
NPI
1831532159
Phone
(952) 997-3020
Address
7300 147TH ST W STE 204
Enumeration Date
17 April 2013
Last Update Date
31 December 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9529973020
Graduation Year
2009 (17 years ago)
PAC ID
5294178596
Group Practice PAC ID
6406752492
Professional Enrollment ID
I20240202002981
Address ID
MN551247850AP7300XWXXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for ROBERT JOHN BOULEY (MA, LPCC)

  • 7300 147TH ST W STE 204

    APPLE VALLEY, MN 551247850

    Phone: (952) 997-3020

    Fax: (952) 997-3026

    Type: Location

  • 4969 Olson Memorial Hwy

    Golden Valley, MN 554225138

    Phone: (763) 575-8086

    Fax: (320) 774-0415

    Type: Location

  • 1315 Girard Ave N

    Minneapolis, MN 554113128

    Phone: (612) 230-6270

    Fax: (612) 522-7061

    Type: Location

  • 14115 James Rd Ste 305

    Rogers, MN 55374

    Phone: (763) 575-8086

    Fax: (320) 774-0415

    Type: Location

  • 1900 SILVER LAKE RD NW STE 110

    NEW BRIGHTON, MN 551121789

    Phone: (651) 628-9566

    Fax: (651) 628-0411

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240202002981IMental Health CounselorMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55124)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406752492View full group profile
NameSpecialtyState
-GA
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical PsychologistMN
Mental Health CounselorMN
Clinical PsychologistMN
Mental Health CounselorMN
Mental Health CounselorMN
Mental Health CounselorMN
-MN

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Frequently asked questions

Is ROBERT JOHN BOULEY (MA, LPCC) listed with a National Provider Identifier?
Yes — ROBERT JOHN BOULEY (MA, LPCC) has NPI 1831532159 on file in the registry.
Is there an active status for ROBERT JOHN BOULEY (MA, LPCC)?
For scheduling context, ROBERT JOHN BOULEY (MA, LPCC) is shown as active in the registry.
What clinical focus is listed for ROBERT JOHN BOULEY (MA, LPCC)?
At a glance, ROBERT JOHN BOULEY (MA, LPCC) is tied to Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ROBERT JOHN BOULEY (MA, LPCC)?
Travel planning: use Apple Valley, Minnesota as the reference point for ROBERT JOHN BOULEY (MA, LPCC), then confirm.
What does 5 location(s) imply?
5 practice locations appear in the available data.

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