MRS. MARY JANE BOUCHER (NPI# 1750502241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750502241 |
| Entity Type | Individual |
| Full Name | MRS. MARY JANE BOUCHER |
| Credential | LCDP |
| Practice Address |
Codac Cranston 1052 Park Ave Cranston RI 02910 |
| Mailing Address |
15 Sarah Teft Dr Warwick RI 02889 |
| Practice Telephone | 4014615056 |
| Mailing Telephone | 4017375596 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LCDP-135 | RI | Behavioral Health & Social Service Providers |
| Street Address |
CODAC CRANSTON 1052 PARK AVE |
| City | CRANSTON |
| State | RI |
| Zip Code | 02910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417443441 | Luis Guzman | Durable Medical Equipment & Medical Supplies | 29 Rolfe Square, Cranston, MA 02910 | 2018-07-02 |
| 1023535010 | Sarah Pagliarini | Nurse Practitioner | 725 Reservoir Ave Ste 308, Cranston, RI 02910 | 2017-08-29 |
| 1861890105 | Marissa Falco | Counselor | 1471 Elmwood Avenue, Cranston, RI 02910 | 2014-12-19 |
| 1952702425 | Lauren Beth Shibley | Counselor | 825 Pontiac Avenue Apt 14101, Cranston, RI 02910 | 2014-09-15 |
| 1831516632 | Kelly Kilmartin | Counselor | 471 Elmwood Avenue, Cranston, RI 02910 | 2014-03-19 |
| 1376784827 | Michael Eric Schaffer | Counselor | 989 Reservoir Ave Ste 104, Cranston, RI 02910 | 2009-03-13 |
| 1639384829 | Dolores Maiello Ciambrone | Social Worker | 145 Harmon Ave, Cranston, RI 02910 | 2007-05-11 |
| 1134250715 | Michele Bailey Chaudhry | Social Worker | 935 Reservoir Ave, Cranston, RI 02910 | 2007-03-08 |
| 1487703658 | Karen M Mega | Dentist | 567 Reservoir Ave, Cranston, RI 02910 | 2007-01-09 |
| 1760544605 | Hannah Baker | Counselor | 38 Grace St Fl 1, Cranston, RI 02910 | 2006-12-15 |
| Find all providers in zip 02910 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134780067 | Jamie Lynn Souza | Counselor | 1257 Cranston St, Cranston, RI 02920-7315 | 2019-06-21 |
| 1669830402 | Meredith Frost | Counselor | 105 Sockanosset Cross Rd Ste 200, Cranston, RI 02920-5560 | 2016-02-08 |
| 1730550096 | Rebecca Flores | Counselor | 78 Brayton Ave, Cranston, RI 02920-3307 | 2015-10-13 |
| 1407267719 | Victoria Sue Monnett | Counselor | 14 Starline Way, Cranston, RI 02921-3409 | 2014-05-09 |
| 1609295641 | Bethany Contreras | Counselor | 40 Howard Ave, Cranston, RI 02920-3031 | 2014-04-07 |
| 1356775365 | Nikolai Blinow | Counselor | 897 Reservoir Ave, Cranston, RI 02910-4435 | 2013-08-27 |
| 1851545669 | S.t.e.p.s. | Counselor | 678 Park Ave, Suite #2, Cranston, RI 02910-2114 | 2008-11-06 |
| 1902085467 | Greater Ri Addiction Services | Counselor | 1704 Broad St, Cranston, RI 02905-2720 | 2007-10-31 |
| 1770792467 | Caritas Inc | Counselor | 1545 Pontiac Ave, Cranston, RI 02920-4407 | 2007-05-21 |
| 1831280544 | Mary J Mercurio | Counselor | 75 Sockanosset Cross Road, Suite 208, Cranston, RI 02920 | 2006-09-27 |
| Find all providers in CRANSTON | ||||
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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.