STACEY BOURBEAU (NPI# 1891115366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891115366 |
| Entity Type | Individual |
| Full Name | STACEY BOURBEAU |
| Other Name | STACEY ERIN BOURBEAU |
| Credential | BSW |
| Practice Address |
391 Varnum Avenue Lower Level Lowell MA 01854 |
| Mailing Address |
391 Varnum Avenue Lower Level Lowell MA 01854 |
| Practice Telephone | 9783225095 |
| Mailing Telephone | 9783225095 |
| Mailing Fax Number | 9783225097 |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2014-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
391 VARNUM AVENUE LOWER LEVEL |
| City | LOWELL |
| State | MA |
| Zip Code | 01854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780224246 | Alexander C Mellin | Specialist/Technologist | Costello Athletic Center, 275 Riverside Street, Lowell, MA 01854 | 2020-01-13 |
| 1831656131 | Shaquilla U Terry | Behavior Technician | 810 Broadway St, Apt 5, Lowell, MA 01854 | 2019-02-23 |
| 1073010187 | John R Dunn | Counselor | Lowell House Inc, 555 Merrimack Street, Lowell, MA 01854 | 2018-04-06 |
| 1730604661 | Grecia Aybar | Counselor | 11 White Street, Lowell, MA 01854 | 2017-08-11 |
| 1659812550 | Krystal Demmons | Counselor | 371 Varnum Ave, Lowell, MA 01854 | 2017-03-13 |
| 1013270446 | Alexandra Miniati | Internal Medicine | 275 Varnum Ave Riverside Medical Group, Ste 201, Lowell, MA 01854 | 2012-06-20 |
| 1750608923 | Elisha S Bartlett | Social Worker | 391 Varnum Avenue, Lowell, MA 01854 | 2010-04-28 |
| 1871820399 | Sandy Ann Thongkhamsouk | Counselor | 391 Varnum St., Lowell, MA 01854 | 2009-11-04 |
| 1427299007 | Kristin A. Larson | Nurse Practitioner | 220 Pawtucket St Suite 300, University Crossing, Lowell, MA 01854 | 2009-03-12 |
| 1487877049 | Julie Ann Ferrazzani | Counselor | 77 Merrimack St, Unit 1, Lowell, MA 01854 | 2007-04-11 |
| Find all providers in zip 01854 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255947495 | Sophia Isabel Deno | Counselor | 62 2nd Ave, Lowell, MA 01854-2808 | 2020-09-22 |
| 1396367223 | Joey Rossignol | Counselor | 142 Carlisle St, Lowell, MA 01852-5207 | 2020-05-14 |
| 1811520638 | Douglas Weiskopf | Counselor | 27 Jackson St Apt 334, Lowell, MA 01852-2142 | 2020-02-20 |
| 1891342986 | Olivia Ruby Miller-nuzzo | Counselor | 184 Methuen St, Lowell, MA 01850-2134 | 2019-08-22 |
| 1366909665 | Trinity Care Associate | Counselor | 100 Merrimack St Ste 201, Lowell, MA 01852-1707 | 2019-02-23 |
| 1437621240 | Innerzension Therapy LLC | Counselor | 322 N Bloomington St, Suite D, Lowell, AR 72745-0000 | 2018-12-19 |
| 1407325277 | Carissa Haberlin | Counselor | 336 W Lakeview Dr, Lowell, IN 46356-1261 | 2018-11-21 |
| 1619443439 | Morgan Thomason | Counselor | 1603 Park St, Lowell, AR 72745-8882 | 2018-10-18 |
| 1740769728 | Sokharith Mey, Md, Pllc | Counselor | 1075 Westford St Ste 204, Lowell, MA 01851-2845 | 2018-08-09 |
| 1902305253 | The Megan House Foundation, Inc. | Counselor | 32 Berry Rd, Lowell, MA 01854-1402 | 2018-02-01 |
| Find all providers in LOWELL | ||||
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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.