Active NPI
Jean Louise Bourque, LCDC,MS
- Addiction (Substance Use Disorder) Counselor
- Vidor, TX
National Provider Identifier
1770413346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 14001
- Practice address
- 165 Fir LN
Vidor, TX 77662-9206 - Phone
- (903) 920-3964
- NPI assigned
- May 22, 2026
- Last updated
- May 22, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 14001 | TX | Primary |
Addresses
Primary practice location
165 Fir LN
Vidor, TX 77662-9206
Mailing address
165 Fir LN
Vidor, TX 77662-9206
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14001 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779408000000",
"number": "1770413346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 FIR LN",
"city": "VIDOR",
"state": "TX",
"postal_code": "776629206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 FIR LN",
"city": "VIDOR",
"state": "TX",
"postal_code": "776629206",
"telephone_number": "903-920-3964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURQUE",
"first_name": "JEAN",
"middle_name": "LOUISE",
"credential": "LCDC,MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-05-22",
"last_updated": "2026-05-22",
"certification_date": "2026-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "14001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vidor, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.