Alexandra Bousquet
Individual provider Active NPI Mental Health Counselor · Stow, OH
NPI 1508303777 · NPPES record last updated Jan 26, 2017
Key facts
- NPI
- 1508303777
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- C.1600256 (OH)
- Practice address
- 3417 Sanford Ave
Stow, OH 44224-4643 - Phone
- (574) 261-9311
- NPI assigned
- Jan 26, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.1600256 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reach Counseling Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C.1600256 | OH | Yes |
Addresses
Primary practice location
3417 Sanford Ave
Stow, OH 44224-4643
Mailing address
3417 Sanford Ave
Stow, OH 44224-4643
Phone (574) 261-9311
Other providers in Stow, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.