Sean G Debourcy, LISW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

06293 Issued in IA

Practice address

638 S Bluff Blvd
Clinton, IA 52732-4742

Phone

(563) 243-5633

Fax

(563) 243-0936

NPI assigned

Mar 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cornerstone Wellness Center LLC 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Cornerstone Wellness Center LLC

  • Mental Health Counselor
  • Clinton, IA
  • NPI 1730292996

  IA

  Medicare reassignment Care Compare group NPD
• Excelsior Ranch

  • Mental Health Occupational Therapist
  • Princeton, IA
  • NPI 1306638119
  NPD

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972632768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 S BLUFF BLVD",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324742",
            "telephone_number": "563-243-5633",
            "fax_number": "563-243-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 S BLUFF BLVD",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324742",
            "telephone_number": "563-243-5633",
            "fax_number": "563-243-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOURCY",
        "first_name": "SEAN",
        "middle_name": "G",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "06293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Daniels, NP
• Kathleen Davenport, COTA
• Brittney Davis, DPT
• Hilary Elaine Davis, LMFT
• Donovan Day
• Stephen Michael Decker, DDS
• Emma Marie Deem
• Lindsay M Demarlie, LISW
• Dennis a. Hinson O.D.,P.C.
• Mathew Determan

• All providers in Clinton, IA
• Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.