Rebecca Grace Bouras, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC012011 Issued in GA

Practice address

4073 Highway 53
Hoschton, GA 30548-2305

Phone

(770) 882-5884

NPI assigned

Jan 1, 2024

Last updated

Jan 1, 2024By the provider in NPPES

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

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northeast Georgia Psychological Services LLC

  • Clinical Psychologist
  • Hoschton, GA
  • NPI 1407230410
  Medicare reassignment NPD

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

{
    "created_epoch": "1704067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704067200000",
    "number": "1417726480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 FREEMAN BROCK RD",
            "city": "AUBURN",
            "state": "GA",
            "postal_code": "300112634",
            "telephone_number": "310-497-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4073 HIGHWAY 53",
            "city": "HOSCHTON",
            "state": "GA",
            "postal_code": "305482305",
            "telephone_number": "770-882-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURAS",
        "first_name": "REBECCA",
        "middle_name": "GRACE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-01",
        "last_updated": "2024-01-01",
        "certification_date": "2023-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC012011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Powell
• Cameron Blake, PSYD
• Blox Ms Sellers LLC
• Britney Huali Borges, LCSW
• Marc-Yriane Borieux, M.D.
• Braselton Pediatrics, LLC
• Braselton Pediatrics, PC
• Lydia Breer, LCSW
• Lisa Kay Brennan, MAT, CCC,-SP
• Bridge Medix

• Professional Counselor in Hoschton, GA
• Providers in Hoschton, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.