Individual provider Active NPI

Tonyarae Catherine Bouvier, PLMHP MSW

  • Clinical Social Worker
  • Papillion, NE
National Provider Identifier
1699018382
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9818 Issued in NE
Practice address
1413 South Washington Street Suite 300
KVC Behavioral Health
Papillion, NE 68046
Phone
(402) 885-1859
NPI assigned
Apr 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9818 NE Primary

Addresses

Primary practice location

1413 South Washington Street Suite 300
KVC Behavioral Health
Papillion, NE 68046

Mailing address

639 Oakland Dr
Council Bluffs, IA 51503-1890
Phone (402) 679-2611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20190701000124 IA Practitioner - Clinical Social Worker 4385978063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19971 Beverly Manor LN
Council Bluffs, IA 51503-5497
Phone (402) 679-2611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9818NEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Therapy, PC Clinical CurrentSince Jul 1, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1699018382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 OAKLAND DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515031890",
            "telephone_number": "402-679-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 SOUTH WASHINGTON STREET SUITE 300",
            "address_2": "KVC BEHAVIORAL HEALTH",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "68046",
            "telephone_number": "402-885-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUVIER",
        "first_name": "TONYARAE",
        "middle_name": "CATHERINE",
        "credential": "PLMHP MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "9818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

Verify at the official NPI Registry.