Alixandra Boucher

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC015305 Issued in PA

Practice address

4601 Market St
Philadelphia, PA 19139-4636

Phone

(215) 590-7555

NPI assigned

Nov 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: alixandra.boucher.1@32853.direct.athenahealth.com

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1023728029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394636",
            "telephone_number": "617-794-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394636",
            "telephone_number": "215-590-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "ALIXANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-30",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "MH11666",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC015305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Andrew Botti, M.D.
• Paul Devine Bottone, M.D.
• Alexander Botwick, D.M.D.
• Benchaa Boualam, MD
• Hadi Bouali
• Noelle Elizabeth Boucher, PA-C
• Tamara Solange Boucher, PA-C
• Mark Boudewijns
• George E Boudreau, DMD
• Oumaima Bougazzoul, MD

• Professional Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.