JENNIFER L BOURQUE (NPI# 1518288653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518288653 |
| Entity Type | Individual |
| Full Name | JENNIFER L BOURQUE |
| Credential | LCSW |
| Practice Address |
1695 Main St Ste 401 Springfield MA 01103-1348 |
| Practice Telephone | 4137395572 |
| Practice Fax Number | 4137399972 |
| Mailing Telephone | 4137395572 |
| Mailing Fax Number | 4137399972 |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2010-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
215041 | MA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699209320 | Jennifer Lynne Bourque | Behavior Technician | 10252 Se Us Highway 441, Unit 3 & 4, Belleview, FL 34420-6819 | 2017-04-19 |
| Street Address |
1695 MAIN ST STE 401 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01103-1348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447561055 | Karen Jasper | Counselor | 1695 Main St Ste 401, Springfield, MA 01103-1348 | 2010-06-29 |
| 1508187535 | Raquel Rivas | Counselor | 1695 Main St Ste 401, Springfield, MA 01103-1348 | 2010-06-14 |
| 1407177421 | Ryan Francis Togneri | Counselor | 1695 Main St Ste 401, Springfield, MA 01103-1348 | 2010-06-14 |
| 1225359342 | Gary Newcomb | Counselor | 1695 Main St Ste 401, Springfield, MA 01103-1348 | 2010-06-14 |
| 1922329945 | Darrell Mcswain Jr. | Counselor | 1695 Main St Ste 401, Springfield, MA 01103-1348 | 2010-06-14 |
| 1588985576 | Victoria Harley | Social Worker | 1695 Main St Ste 401, Springfield, MA 01103-1348 | 2010-06-14 |
| 1487975470 | Michelle Blanchard | Counselor | 1695 Main St Ste 401, Springfield, MA 01103-1348 | 2010-06-14 |
| 1639490741 | Amanda J Lichtel | Counselor | 1695 Main St Ste 401, Springfield, MA 01103-1348 | 2010-06-13 |
| 1477874576 | Deborah Lynn Mazza | Counselor | 1695 Main St Ste 401, Springfield, MA 01103-1348 | 2010-06-13 |
| 1821319922 | Nathaniel Pike | Social Worker | 1695 Main St Ste 401, Springfield, MA 01103-1348 | 2010-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336790609 | Mahmoud Al Homsi | Dentist | 41 Taylor St. 4th Fl, Springfield, MA 01103 | 2019-09-26 |
| 1427521749 | Pedro Cruz | Student in an Organized Health Care Education/Training Program | 95 Frank B Murray, Springfield, MA 01103 | 2019-01-09 |
| 1003325010 | Amber Lynn Chisholm | Counselor | 130 Maple St., Springfield, MA 01103 | 2017-09-21 |
| 1750737391 | Mande' Counseling | Community/Behavioral Health | 1365 Main St Suite 401, Springfield, MA 01103 | 2016-05-13 |
| 1528467248 | Amanda M Galloway | Physician Assistant | 1038-1050 Main St, Springfield, MA 01103 | 2014-08-19 |
| 1114326113 | Anne Marie Belinda | Nurse Practitioner | 1049 Main St., Springfield, MA 01103 | 2014-08-15 |
| 1538575295 | Sunrise Behavioral Health Clinic, LLC | Clinic/Center | 95 Frank B. Murray Street, Springfield, MA 01103 | 2014-07-02 |
| 1548675093 | Jessica Lynn Pasalacqua | Dietitian, Registered | 870 Main St., Springfield, MA 01103 | 2014-06-24 |
| 1003220443 | Ivan Rosario | Counselor | 1695 Main St Ste400, Springfield, MA 01103 | 2014-06-13 |
| 1275964769 | Leeandrew Rick Wilson | Counselor | 1695 Main St., Springfield, MA 01103 | 2013-12-09 |
| Find all providers in zip 01103 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619576022 | Christine Cremonni | Counselor | 451 Wayne Ave, Springfield, PA 19064-2618 | 2020-10-19 |
| 1710585252 | Andrada Mihaila | Counselor | 120 Maple St Ste 301, Springfield, MA 01103-2216 | 2020-10-16 |
| 1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
| 1205443462 | India Iasia Kyles | Counselor | 82 Tilton St, Springfield, MA 01109-2332 | 2020-09-30 |
| 1437765161 | Sarissa Joy Adams | Counselor | 1915 E Nottingham St, Springfield, MO 65804-7733 | 2020-09-18 |
| 1568098952 | Jennifer Corsi | Counselor | 130 Maple St Ste 201, Springfield, MA 01103-2214 | 2020-03-17 |
| 1245865500 | Annette Lynn Brandenburg | Counselor | 1736 E Sunshine St Ste 811, Springfield, MO 65804-1334 | 2020-03-06 |
| 1962045443 | Emilie Noel Phillips | Counselor | 3826 E Lomita St, Springfield, MO 65809-3710 | 2019-10-28 |
| 1265082234 | Sierra Jane Forney | Counselor | 98 Garnet St, Springfield, MA 01129-1908 | 2019-09-12 |
| 1700438678 | Julie Ann Blythe | Counselor | 620 N Walnut St, Springfield, IL 62702-4930 | 2019-07-11 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01103 |
Please comment or provide details below to improve the information on JENNIFER L BOURQUE.
| 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.