Sydna Elizabeth Bougere, LCMHC

Individual provider Active NPI Mental Health Counselor · Rutherfordton, NC

NPI 1497907497 · NPPES record last updated Jun 6, 2022

Key facts

NPI
1497907497
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
10779 (NC)
Practice address
356 Charlotte Rd
Rutherfordton, NC 28139
Phone
(828) 287-7945
NPI assigned
Oct 21, 2008
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10779NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Solid Foundations Counseling Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 10779 NC
Mental Health Counselor 101YM0800X 10779 NC Yes

Addresses

Primary practice location

356 Charlotte Rd
Rutherfordton, NC 28139

Mailing address

356 Charlotte Rd
Rutherfordton, NC 28139-2916
Phone (828) 287-7945

Other practice location 1

510 W 29th St
Cheyenne, WY 82001-2760
Phone (307) 632-9362

Other identifiers

IdentifierTypeStateIssuer
10779OtherNCLICENSE

Other providers in Rutherfordton, NC

All providers in Rutherfordton, NC · Mental Health Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.