Alex Bourque, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15404 Issued in LA

Practice address

8752 Quarters Lake Rd.
BLDG. 9
Baton Rouge, LA 70809

Phone

(225) 922-9122

Fax

(225) 922-9125

NPI assigned

Jul 16, 2024

Sex

Male

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 LA

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, 2019

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 and National Provider Directory roles.

• Clear Minds Behavioral Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baton Rouge, LA
  • NPI 1053869222
  NPD (past)

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1245078146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8752 QUARTERS LAKE RD.",
            "address_2": "BLDG. 9",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70809",
            "telephone_number": "225-922-9122",
            "fax_number": "225-922-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8752 QUARTERS LAKE RD.",
            "address_2": "BLDG. 9",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70809",
            "telephone_number": "225-922-9122",
            "fax_number": "225-922-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURQUE",
        "first_name": "ALEX",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "15404",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "15404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Brown Bourgoyne, OT
• Kesler Joseph Bourgoyne, MD
• Lance Bourgoyne
• Robin Marie Bourgoyne, PLPC, NCC
• Tanya Chauvin Bourgoyne, M.A., CCC-SLP
• Andrea B Bourque, NP
• Ashley Bourque, MA CCC-SLP
• Brooke Delhomme Bourque, PA-C
• Rikki F Bourque, APRN, CPNP
• Taylor Bourque, LPC

• Clinical Social Worker in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Clinical Social Worker in Louisiana

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