Kristen Leanne Bourque, LCSW

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CSW01365 Issued in RI

Practice address

22 Front St
Fall River, MA 02721-4302

Phone

(508) 676-1307

Fax

(508) 674-4493

NPI assigned

Dec 27, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Habit Opco, LLC

  • Methadone Clinic
  • Springfield, MA
  • NPI 1023175072
  NPD (past)
• Habit Opco, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fitchburg, MA
  • NPI 1255034880
  NPD (past)

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293408000000",
    "number": "1265736730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 DOUGLAS RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862785",
            "telephone_number": "401-826-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 FRONT ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027214302",
            "telephone_number": "508-676-1307",
            "fax_number": "508-674-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURQUE",
        "first_name": "KRISTEN",
        "middle_name": "LEANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-27",
        "last_updated": "2010-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "CSW01365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly June Boucher
• Steven Wilfred-Earle Boucher, DMD
• Debra Boudreau, LCSW
• Michael Paul Boudria, PHD
• Nichole Marie Boulay
• Patrisha Bowdre
• Cathy A Bowers, R.D.
• Shannen Elizabeth Box, PA
• Matthew Wayne Boyd II
• Megan Boyd, RN

• Addiction (Substance Use Disorder) Counselor in Fall River, MA
• Providers in Fall River, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.