Individual provider Active NPI

Bridget R Boursiquot, MSW, LICSW

  • Clinical Social Worker
  • Weymouth, MA
National Provider Identifier
1205317674
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
50 Bates Ave
Weymouth, MA 02190-2706
Phone
(607) 759-5499
NPI assigned
Aug 23, 2018
Last updated
Aug 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

50 Bates Ave
Weymouth, MA 02190-2706

Mailing address

50 Bates Ave
Weymouth, MA 02190-2706
Phone (607) 759-5499

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

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1205317674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BATES AVE",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021902706",
            "telephone_number": "607-759-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BATES AVE",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021902706",
            "telephone_number": "607-759-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURSIQUOT",
        "first_name": "BRIDGET",
        "middle_name": "R",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.