Active NPI
Patricia Bouffard, LCSW
- Social Worker
- Holyoke, MA
National Provider Identifier
1053618983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 227357
- Practice address
- 50 Commercial St
Holyoke, MA 01040-4704 - Phone
- (413) 707-0861
- NPI assigned
- Feb 11, 2011
- Last updated
- Sep 20, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 227357 | MA | Primary |
Addresses
Primary practice location
50 Commercial St
Holyoke, MA 01040-4704
Mailing address
50 Commercial St
Holyoke, MA 01040-4704
Phone (203) 695-9290
Other practice location 1
130 Pine St
Holyoke, MA 01040-4150
Phone (413) 538-8188 ext. 58597
Other practice location 2
142 Griggs St
Waterbury, CT 06704-3110
Phone (203) 574-4180
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227357 | Other | MA | LICENSED CERTIFIED SOCIAL WORKER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227357 | MA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmore, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Wellmore, Inc.-Therapeutic Shelter
- Substance Use Disorder Rehabilitation Clinic/Center
- Waterbury, CT
- NPI 1336407915
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663632000000",
"number": "1053618983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 COMMERCIAL ST",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "010404704",
"telephone_number": "203-695-9290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 COMMERCIAL ST",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "010404704",
"telephone_number": "413-707-0861"
}
],
"practiceLocations": [
{
"address_1": "130 Pine St",
"address_purpose": "LOCATION",
"city": "Holyoke",
"state": "MA",
"postal_code": "010404150",
"country_code": "US",
"telephone_number": "413-538-8188 x58597",
"fax_number": "413-417-2927",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "142 Griggs St",
"address_purpose": "LOCATION",
"city": "Waterbury",
"state": "CT",
"postal_code": "067043110",
"country_code": "US",
"telephone_number": "203-574-4180",
"fax_number": "203-578-1419",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOUFFARD",
"first_name": "PATRICIA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-11",
"last_updated": "2022-09-20",
"certification_date": "2022-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "227357",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED CERTIFIED SOCIAL WORKER",
"identifier": "227357",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Holyoke, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.