Dail Marie Bouchard, LADC-1, CADAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

477 Issued in MA

Practice address

111 Edgartown Vineyard Haven Rd
Vineyard Haven, MA 02568-4036

Phone

(508) 693-7900

Fax

(508) 696-0401

NPI assigned

Sep 7, 2010

Last updated

Sep 7, 2010By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1679880165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EDGARTOWN VINEYARD HAVEN RD",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025684036",
            "telephone_number": "508-693-7900",
            "fax_number": "508-696-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 EDGARTOWN VINEYARD HAVEN RD",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "025684036",
            "telephone_number": "508-693-7900",
            "fax_number": "508-696-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "DAIL",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LADC-1, CADAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Vineyard Haven, MA
• Providers in Vineyard Haven, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; 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.