Kim A Bourgette, MA
Individual provider Active NPI Mental Health Counselor · Poulsbo, WA
NPI 1033820139 · NPPES record last updated Dec 8, 2022
Key facts
- NPI
- 1033820139
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- MC61028132 (WA)
- Practice address
- 19550 Scoter LN NE
Poulsbo, WA 98370-6545 - Phone
- (208) 720-6593
- NPI assigned
- Dec 8, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC61028132 | WA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC61028132 | WA | Yes |
Addresses
Primary practice location
19550 Scoter LN NE
Poulsbo, WA 98370-6545
Mailing address
19550 Scoter LN NE
Poulsbo, WA 98370-6545
Phone (208) 720-6593
Other providers in Poulsbo, WA
- Boudreaux Optics, P.L.L.C
- Paul Boudreaux
- John Frank Boulukos
- Ginger Bouma
- Boundless Pharmaceuticals LLC
- Michael J Bowman
- Pamala Jean Bowman
- Lorin Debora Boynton
- Cynthia Marie Brady
- Aaron Brake
All providers in Poulsbo, WA · Mental Health Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.