Alyssa Boudreau, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

577 Tiogue Ave
Coventry, RI 02816-5687

Phone

(401) 644-2819

NPI assigned

Nov 13, 2018

Last updated

Nov 16, 2021By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Community Care Alliance

  • Community/Behavioral Health Agency
  • Woonsocket, RI
  • NPI 1013288083
  NPD (past)

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1386112985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 SCHOOL ST APT 3",
            "city": "CENTRAL FALLS",
            "state": "RI",
            "postal_code": "028631883",
            "telephone_number": "401-644-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 TIOGUE AVE",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028165687",
            "telephone_number": "401-644-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "ALYSSA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "RI",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BKD New England Bay LLC (Brookdale Centre of New England)
• Mark G Blasbalg, O.D.
• Tammy Jean Bonanno
• Janet M Bood, CPHT
• Kathie A Bouchard, CCC-SLP
• Kayla Lynn Bourbon, LMFT
• Jimmette N Brooks, M.D.
• Bridget Brothers
• Amanda Brown
• Shawn Brown, RPH

• Mental Health Counselor in Coventry, RI
• Providers in Coventry, RI by specialty
• Mental Health Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.