Christina Bournique

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.1100046-SUPV Issued in OH

Practice address

2440 Dawnlight Ave
Columbus, OH 43211-1934

Phone

(614) 301-2714

NPI assigned

Feb 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1790144236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 DAWNLIGHT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432111934",
            "telephone_number": "614-301-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 DAWNLIGHT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432111934",
            "telephone_number": "614-301-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNIQUE",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "ICDC.101143-CS",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.1100046-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Erin Bourget
• Jamie Bourn
• Jon Bourn, PH.D.
• Michael V Bourn, DO
• Brittany Nicole Bourne, APRN-CNP
• Sharon Bout-Tabaku, M.D.
• Petra Nihad Boutros, DMD
• Julie Anne Bouttamy, RD, LD
• Steven R Bouyack, PA-C
• Bouza Services Inc

• Mental Health Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.