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1609176650 NPI number — MEGAN E BOUSQUET MA, ATR, LPC

NPI Number: 1609176650
Health Care Provider/Practitioner: MEGAN E BOUSQUET MA, ATR, LPC

Information about “1609176650” NPI (MEGAN E BOUSQUET MA, ATR, LPC) exists in 1609176650 in HTML format HTML  |  1609176650 in plain Text format TXT  |  1609176650 in PDF (Portable Document Format) PDF  |  1609176650 in an XML format XML  formats.

NPI Number : 1609176650 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609176650",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BOUSQUET",
    "FirstName": "MEGAN",
    "MiddleName": "E",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MA, ATR, LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KELLEY",
    "OtherFirstName": "MEGAN",
    "OtherMiddleName": "E",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "LPC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "956 N AMERICAN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHILADELPHIA",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19123-2230",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "609-790-1716",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "737 N 4TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PHILADELPHIA",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19123-2907",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "215-436-9129",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/25/2010",
    "LastUpdateDate": "01/28/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "PRC14101",
          "LicenseNumberStateCode": "DC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "PC008464",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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