Kristina Bourgoin, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1794 Issued in MA

Practice address

241 Dresser Hill Rd
Dudley, MA 01571-6328

Phone

(603) 505-0326

NPI assigned

Apr 4, 2017

Last updated

Jul 28, 2023By 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 3

Addresses

Other names 1

• Kristina Hanley Former name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kristina Bourgoin, LMFT, LLC

  • Marriage & Family Therapist
  • Dudley, MA
  • NPI 1295514008

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1396278784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 DRESSER HILL RD",
            "city": "DUDLEY",
            "state": "MA",
            "postal_code": "015716328",
            "telephone_number": "603-505-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 DRESSER HILL RD",
            "city": "DUDLEY",
            "state": "MA",
            "postal_code": "015716328",
            "telephone_number": "603-505-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGOIN",
        "first_name": "KRISTINA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "1794",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "1794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "HANLEY",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jason Avakian
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• James Michael Bilodeau, DC
• Lillian Joan Bonin, M.S., L.M.H.C.
• Susan Boyle, RRT
• Nicole Chege
• William Mark Coffey, LAT, CSCS
• Cross Roads Trolley Equipment Inc.
• Cross Roads Trolley, Inc

• Marriage & Family Therapist in Dudley, MA
• Providers in Dudley, MA by specialty
• Marriage & Family Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.