Stacey Bourbeau, BSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

391 Varnum Avenue Lower Level
Lowell, MA 01854

Phone

(978) 322-5095

NPI assigned

Apr 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacey Erin Bourbeau Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1891115366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 VARNUM AVENUE",
            "address_2": "LOWER LEVEL",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01854",
            "telephone_number": "978-322-5095",
            "fax_number": "978-322-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 VARNUM AVENUE LOWER LEVEL",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01854",
            "telephone_number": "978-322-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURBEAU",
        "first_name": "STACEY",
        "credential": "BSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "BOURBEAU",
            "middle_name": "ERIN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Abigail Nicole Bosse
• Boston Vamc
• Boston Vamc
• Katherine Bouchard
• Jeanne Claire Boudreau, LICSW
• Leanne Bourgeois
• Kayla Boutin
• Asmaa Bouziane, RPH
• Natalie Sarah Ayari Bowen
• Kerrin Bowers

• Mental Health Counselor in Lowell, MA
• Providers in Lowell, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.