Individual provider Active NPI

Sean Bourgeoise, MA

  • Addiction (Substance Use Disorder) Counselor
  • Chicopee, MA
National Provider Identifier
1841807112
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
628 Center St
Chicopee, MA 01013-1589
Phone
(413) 233-1478
NPI assigned
Sep 30, 2020
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

628 Center St
Chicopee, MA 01013-1589

Mailing address

628 Center St
Chicopee, MA 01013-1589
Phone (413) 233-1478

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 Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgewell Health PC Addiction (Substance Use Disorder) Current Accepting new patients
Community Health Care, Inc. Addiction (Substance Use Disorder) CurrentSince Oct 4, 2020 Accepting new patients
413Therapy Group, Inc. Past Accepting new patients
Community Physicians PC PastSince Oct 4, 2020 Accepting new patients

Locations

628 Center St
Chicopee, MA 01013
Phone (413) 746-0051

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1841807112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 CENTER ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010131589",
            "telephone_number": "413-233-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 CENTER ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010131589",
            "telephone_number": "413-233-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOISE",
        "first_name": "SEAN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicopee, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.