Active NPI
Tammy Marie Boucher, LICSW
- Clinical Social Worker
- Dover, NH
National Provider Identifier
1295963718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1471
- Practice address
- 728 Central Ave
Dover, NH 03820-3494 - Phone
- (603) 742-5662
- Fax
- (603) 743-5106
- NPI assigned
- Jun 23, 2009
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1471 | NH | Primary |
Addresses
Primary practice location
728 Central Ave
Dover, NH 03820-3494
Mailing address
729 Tri City Rd
Somersworth, NH 03878-1337
Phone (603) 781-0250
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 |
|---|---|---|---|
| 1471 | NH | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245715200000",
"number": "1295963718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "729 TRI CITY RD",
"city": "SOMERSWORTH",
"state": "NH",
"postal_code": "038781337",
"telephone_number": "603-781-0250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "728 CENTRAL AVE",
"city": "DOVER",
"state": "NH",
"postal_code": "038203494",
"telephone_number": "603-742-5662",
"fax_number": "603-743-5106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUCHER",
"first_name": "TAMMY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-23",
"last_updated": "2009-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NH",
"license": "1471",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dover, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.