Individual provider Active NPI

Haley Nicole Boushee

  • Clinical Social Worker
  • Crookston, MN
National Provider Identifier
1346187192
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
32053 Issued in MN
Practice address
603 Bruce St
Crookston, MN 56716-2914
Phone
(218) 281-3940
NPI assigned
Apr 30, 2026
Last updated
Apr 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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 32053 MN Primary

Addresses

Primary practice location

603 Bruce St
Crookston, MN 56716-2914

Mailing address

603 Bruce St
Crookston, MN 56716-2914
Phone (218) 281-3940

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL CredibleBH.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20260507003017 MN Practitioner - Clinical Social Worker 7719455799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

603 Bruce St
Crookston, MN 56716-2914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alluma, Inc. CurrentSince Apr 30, 2026 Accepting new patients

Locations

603 Bruce St
Crookston, MN 56716
Phone (218) 281-3940

1422 Central Ave NE
East Grand Forks, MN 56721
Phone (218) 773-6102

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1777507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1346187192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-281-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BRUCE ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162914",
            "telephone_number": "218-281-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSHEE",
        "first_name": "HALEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-30",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "32053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CredibleBH.com",
            "affiliation": "N",
            "endpointDescription": "online HIE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "603 Bruce St",
            "city": "Crookston",
            "state": "MN",
            "country_code": "US",
            "postal_code": "567162914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crookston, MN

Sources for this page

Verify at the official NPI Registry.