Lynn Bourque, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.1302235 Issued in OH

Practice address

5500 S Marginal Rd Ste 110
Cleveland, OH 44103-1009

Phone

(614) 487-8748

NPI assigned

Jan 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1851809446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 S MARGINAL RD STE 110",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441031009",
            "telephone_number": "614-487-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 S MARGINAL RD STE 110",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441031009",
            "telephone_number": "614-487-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURQUE",
        "first_name": "LYNN",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1302235",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1302235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Renee Bounds
• Jennica Phenide Bouquet
• Demetrios Bourdakos, MD
• Gregory Bourdakos, M.D.
• Toby Bourisseau, CNS
• Nicholas Bourque
• Rany Bous, BDS
• Lea Bouserhal
• Joseph Charles Boustani
• Antoine Boustany, MD

• Social Worker in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.