Organization Active NPI

Emdr Therapy Solutions and Wellness LLC

  • Clinical Social Worker
  • Plymouth, MA
National Provider Identifier
1013783661
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
EMDR THERAPY SOLUTIONS AND WELLNESS LLC
Practice address
2277 State Rd Unit D
Plymouth, MA 02360-7111
Phone
(508) 266-5971
NPI assigned
Nov 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Natasha Bourgoin, LICSWNPI 1205421500
Title
Ceo
Phone
(617) 953-7845

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2277 State Rd Unit D
Plymouth, MA 02360-7111

Mailing address

5 Drum Dr
Plymouth, MA 02360-2711
Phone (617) 953-7845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250408000667 MA Part B Supplier - Clinic/Group Practice 0042734485 Receives reassigned benefits from 3 practitioners
Practice locations: Plymouth, MA

National Provider Directory

National Provider Directory

Locations

2277 State Rd
Unit D
Plymouth, MA 02360
Phone (508) 266-5971

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1013783661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DRUM DR",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602711",
            "telephone_number": "617-953-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 STATE RD UNIT D",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023607111",
            "telephone_number": "508-266-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMDR THERAPY SOLUTIONS AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-27",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A",
        "authorized_official_last_name": "BOURGOIN",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-953-7845",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.