Memory Boucher, MS, BA, ADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

19 N 5TH St
Fort Smith, AR 72901-2137

Phone

(479) 785-4083

NPI assigned

Mar 25, 2020

Last updated

Mar 25, 2020By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts, Master of Science

Practice roles

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.

• Harbor House Incorporated of Fort Smith Arkansas

  dba Harbor House, Incorporated

  • Substance Abuse Rehabilitation Facility
  • Fort Smith, AR
  • NPI 1922166123
  NPD (past)

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1720615289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 S 16TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 N 5TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729012137",
            "telephone_number": "479-785-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "MEMORY",
        "credential": "MS, BA, ADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Nicole Booth, MSN, FNP-C
• Borengasser Family Dental, PLLC
• James Wesley Borengasser, D.D.S.
• Alexandria Boss
• Bost, Inc. (Bost C.A.R.E.S.)
• David Lynn Bourne, MS LPC
• Audra Bowen
• Emily Chloe Bower, CF-SLP
• Charles Bowers, PA-S
• John Russell Bowers, DO

• Mental Health Counselor in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.