Bianca J Boucher, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

082689 Issued in NY

Practice address

6006 Number Four Rd
Lowville, NY 13367-3309

Phone

(315) 220-9525

NPI assigned

Jul 20, 2011

Last updated

Jun 18, 2024By the provider in NPPES

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bianca Boucher LCSW PLLC

  dba Sage Mind Therapy

  • Social Worker
  • Lowville, NY
  • NPI 1235990508
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1104114479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6006 NUMBER FOUR RD",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133673309",
            "telephone_number": "315-220-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6006 NUMBER FOUR RD",
            "city": "LOWVILLE",
            "state": "NY",
            "postal_code": "133673309",
            "telephone_number": "315-220-9525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6422 Maple St",
            "address_purpose": "LOCATION",
            "city": "Beaver Falls",
            "state": "NY",
            "postal_code": "133057700",
            "country_code": "US",
            "telephone_number": "315-220-9525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "BIANCA",
        "middle_name": "J",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "079346",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Boucher LCSW PLLC (Sage Mind Therapy)
• Wayne F Bishop, CRNA
• Jackie Blunt, FNP
• Karen Strife Borawski, MA CCCA LIC AUDIOLOG
• Debra J Bosco, LCSW, CASAC
• Jennifer Marie Boucher, MS, OTR/L
• Theodore Brand, CRNA
• Mackenzie Brayman-Purcell
• Gina Brewer, LCSW
• Pamela J Brower, LMSW

• Clinical Social Worker in Lowville, NY
• Providers in Lowville, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.