MELISSA BETH BOUCHARD (NPI# 1164933396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164933396 |
| Entity Type | Individual |
| Full Name | MELISSA BETH BOUCHARD |
| Practice Address |
32411 Briarcrest Knls Farmington Hills MI 48334-1515 |
| Practice Telephone | 9175750823 |
| Mailing Telephone | 9175750823 |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2017-10-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171W00000X | Contractor | Other Service Providers | ||
| N | 172V00000X | Community Health Worker | MI | Other Service Providers | |
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083173629 | Melissa Bouchard | Peer Specialist | 4104 Delta St, San Diego, CA 92113-4113 | 2019-03-13 |
| 1275016792 | Melissa Joann Bouchard | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002-0000 | 2018-09-11 |
| Street Address |
32411 BRIARCREST KNLS |
| City | FARMINGTON HILLS |
| State | MI |
| Zip Code | 48334-1515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264535 | Kiah Bradley | Behavior Technician | 2777 Inkster Rd Suite 100, Farmington Hills, MI 48334 | 2020-10-29 |
| 1417557307 | Carsen D Dresbach | Behavior Technician | 2777 Inster Road Suite 100, Farmington Hills, MI 48334 | 2020-10-29 |
| 1316560303 | Amy K Pruneau LLC | Psychologist | 26755 Middlebelt Rd Ste 140, Farmington Hills, MI 48334 | 2020-05-25 |
| 1366089732 | Vian Aljony | Dental Hygienist | 27273 Arden Park Cir, Farmington Hills, MI 48334 | 2019-12-04 |
| 1699311902 | Sandra Zori | Pharmacist | 27800 Middlebelt Rd, Farmington Hills, MI 48334 | 2019-11-21 |
| 1902450471 | Kianna Marie Garcia | Behavior Technician | 27777 Inkster Rd., Farmington Hills, MI 48334 | 2019-08-01 |
| 1619521176 | Samantha Serra | Behavior Technician | 27777 Inkster Rd Suite 100, Farmington Hills, MI 48334 | 2019-08-01 |
| 1851945398 | Kristen Butler | Behavior Technician | 27777 Inkster Road Suite 100, Farmington Hills, MI 48334 | 2019-08-01 |
| 1104489038 | Katherine Kalsow | Behavioral Analyst | 27777 Inkster Rd. Suite 100, Farmington Hills, MI 48334 | 2019-04-16 |
| 1083178487 | Imee Raterta | Physical Therapist | Ability Works Rehab, 28592 Orchard Lake Rd # 300, Farmington Hills, MI 48334 | 2019-01-30 |
| Find all providers in zip 48334 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026284 | Leah Mae Sindone | Peer Specialist | 22324 Derby Rd, Woodhaven, MI 48183-3700 | 2020-09-04 |
| 1992314728 | Willie Earl Feggins | Peer Specialist | 370 Country Club Rd, Holland, MI 49423-8303 | 2020-07-28 |
| 1831711613 | John Lee Williams Jr. | Peer Specialist | 24400 Schoolcraft, Redford, MI 48239-2633 | 2020-05-14 |
| 1568084861 | Zannie Roy Jackson Jr. | Peer Specialist | 36801 Ann Arbor Trl, Livonia, MI 48150-3422 | 2020-05-11 |
| 1417578865 | Veronica R Vasquez | Peer Specialist | 500 Hancock St # 48602, Saginaw, MI 48602-4224 | 2020-04-27 |
| 1235768680 | Matthew Milz | Peer Specialist | 145o S Lapeer Rd, Oxford, MI 48371-4982 | 2020-04-07 |
| 1558996132 | Camille Jewell Jackson | Peer Specialist | 8181 N Wayne Rd Apt S2147, Westland, MI 48185-3842 | 2020-03-04 |
| 1073146908 | James Laroach | Peer Specialist | 913 W. Homes Suite 200, Lansing, MI 48910 | 2020-02-19 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON HILLS |
| Zip Code | 48334 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.