Theresa Sheryl Bougouneau, M.ED, LADC 1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

21620 Issued in MA

Practice address

31 John St # 2
Attleboro, MA 02703-2027

Phone

(781) 414-0099

NPI assigned

Aug 28, 2012

Sex

Female

Sole proprietor

No

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

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Outreach Behavioral Health and Wellness Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Quincy, MA
  • NPI 1174339857

  MA

  Medicare reassignment NPD
• Outreach Behavioral Health and Wellness Center LLC

  • Community/Behavioral Health Agency
  • Quincy, MA
  • NPI 1841019577
  NPD

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1942558697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 JOHN ST # 2",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027032027",
            "telephone_number": "781-414-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 JOHN ST # 2",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027032027",
            "telephone_number": "781-414-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUGOUNEAU",
        "first_name": "THERESA",
        "middle_name": "SHERYL",
        "credential": "M.ED, LADC 1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "21620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Marie Booth
• Erica Boretti, PT, DPT
• Katherine Elizabeth Borges, MS
• Alana Marie Bouchard
• Sydney Bouchard
• Catherine M Boulay
• Ashley Bourdon, BCBA
• Lauren Bouyea, LCSW
• Jessica Bowen
• Kevin Bowman, MD

• All providers in Attleboro, MA
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; 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.