MARK LYNN BOUCHER (NPI# 1538283569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538283569 |
| Entity Type | Individual |
| Full Name | MARK LYNN BOUCHER |
| Credential | LMFT |
| Practice Address |
1208 9th St Modesto CA 95354-0713 |
| Practice Telephone | 2095584464 |
| Practice Fax Number | 2095584450 |
| Mailing Telephone | 2095584464 |
| Mailing Fax Number | 2095584450 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MFC20703 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LMFT | 106H00000X | 01 |
| Street Address |
1208 9TH ST |
| City | MODESTO |
| State | CA |
| Zip Code | 95354-0713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316968654 | Patricia E Conteh | Nurse Practitioner | 1208 9th St, Modesto, CA 95354-0713 | 2006-07-22 |
| 1699331876 | Kong Meng Vang | Technician | 1208 9th St, Modesto, CA 95354-0713 | 2019-05-14 |
| 1881257426 | Nathan Watkins Woolbright | Technician | 1208 9th St, Modesto, CA 95354-0713 | 2019-04-18 |
| 1508203951 | Elizabeth Purto | Counselor | 1208 9th St, Modesto, CA 95354-0713 | 2013-05-24 |
| 1174877823 | Stanislaus County | Exclusive Provider Organization | 1208 9th St, Modesto, CA 95354-0713 | 2012-11-02 |
| 1568797728 | Maria Alicia Anaya | Counselor | 1208 9th St, Modesto, Modesto, CA 95354-0713 | 2009-10-06 |
| 1528221918 | Daphine Lamb-perrilliat | Counselor | 1208 9th St, Modesto, CA 95354-0713 | 2008-07-07 |
| 1083887491 | Michelle Ann Draper | Counselor | 1208 9th St, Modesto, CA 95354-0713 | 2008-04-07 |
| 1700064193 | Telecare Corporation | Clinic/Center | 1208 9th St, Modesto, CA 95354-0713 | 2008-02-07 |
| 1205013844 | County of Stanislaus | Community/Behavioral Health | 1208 9th St, Modesto, CA 95354 | 2008-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669987301 | Tristan Renee Bowman | Student in an Organized Health Care Education/Training Program | 1700 Mchenry Way, Modesto, CA 95354 | 2017-12-04 |
| 1134647944 | Melissa Kathleen Huizar | Occupational Therapist | 730 17th Street, Modesto, CA 95354 | 2017-08-31 |
| 1861948424 | Daniel Jones | Specialist/Technologist | 224 Eula Drive, Modesto, CA 95354 | 2016-09-01 |
| 1710333976 | Elite First Health | Clinic/Center | 3121 Yosemite Blvd Ste D2, Modesto, CA 95354 | 2016-05-06 |
| 1790169084 | Ronika Rodriguez | Licensed Vocational Nurse | 328 Thrasher Ave, Modesto, CA 95354 | 2015-07-16 |
| 1942688528 | Progressive Home Health and Hospice Care, LLC | Home Infusion | 1619 H Street, Modesto, CA 95354 | 2015-05-14 |
| 1225434277 | Ashley Ann Brown | Case Manager/Care Coordinator | 1000 Needham, Modesto, CA 95354 | 2014-11-18 |
| 1922380518 | Thao Truong | Specialist | 1321 I St Ste #3, Modesto, CA 95354 | 2011-09-09 |
| 1437441938 | Amy Marie Lipomi | Counselor | 613 13th Street, Suite B, Modesto, CA 95354 | 2011-05-03 |
| 1871800813 | Patricia Ashley Dalman | Social Worker | 1321 I Street Suite 3, Modesto, CA 95354 | 2010-09-13 |
| Find all providers in zip 95354 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891303731 | Youth for Christ Central Valley | Marriage & Family Therapist | 1101 M St, Modesto, CA 95354-0755 | 2020-07-16 |
| 1336629229 | Matina Trigo | Marriage & Family Therapist | 420 Downey Ave, Modesto, CA 95354-1301 | 2018-08-20 |
| 1629558903 | Central Valley Therapeutic Alliance, Inc. | Marriage & Family Therapist | 201 E Orangeburg Ave Ste F, Modesto, CA 95350-5355 | 2018-08-16 |
| 1659888543 | Dr. Irit Goldman Psy.d Lmft | Marriage & Family Therapist | 1604 Ford Ave Ste 1, Modesto, CA 95350-4649 | 2018-01-02 |
| 1013461748 | Pamela Christine Remides | Marriage & Family Therapist | 615 14th St, Modesto, CA 95354-2504 | 2016-08-10 |
| 1073964805 | Dwight Simpson Sr. | Marriage & Family Therapist | 1705 Ardmore Ave, Modesto, CA 95350-4100 | 2016-06-22 |
| 1811373640 | Melissa Ruiz | Marriage & Family Therapist | 5815 Stoddard Rd Suite 600, Modesto, CA 95356 | 2015-08-04 |
| 1750620902 | Jacquelyn Irene Mitchell | Marriage & Family Therapist | 3049 Darlene Ln, Modesto, CA 95355-4157 | 2013-02-07 |
| 1891046512 | Brittany Elizabeth Rushin | Marriage & Family Therapist | 1015 12th St Ste 11, Modesto, CA 95354-0838 | 2012-09-20 |
| 1467715979 | Angela Jean Kelley | Marriage & Family Therapist | 1809 Lobero Ln, Modesto, CA 95355-2521 | 2012-06-19 |
| Find all providers in MODESTO | ||||
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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.