Individual provider Active NPI

Erika Bourque, LPC

  • Professional Counselor
  • New Haven, CT
National Provider Identifier
1871269373
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6327 Issued in CT
Practice address
374 Grand Ave
New Haven, CT 06513-3733
Phone
(203) 777-7411
NPI assigned
Aug 17, 2021
Last updated
Jan 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6327 CT Primary

Addresses

Primary practice location

374 Grand Ave
New Haven, CT 06513-3733

Mailing address

374 Grand Ave
New Haven, CT 06513-3733
Phone (203) 777-7411

Other names 1

  • Erika K Moya Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118001071 CT Practitioner - Mental Health Counselor 0345774097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6327CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fair Haven Community Health Clinic Inc Current Accepting new patients
Fair Haven Community Health Clinic, Inc CurrentSince Sep 6, 2024 Accepting new patients
Fair Haven Community Health Clinic, Inc CurrentSince Sep 6, 2024 Accepting new patients

Locations

374 Grand Ave
New Haven, CT 06513
Phone (203) 752-5203

Organizations & group practices 3

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1871269373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133733",
            "telephone_number": "203-777-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURQUE",
        "first_name": "ERIKA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "6327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIKA",
            "last_name": "MOYA",
            "middle_name": "K",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.