Bouchard, Richard J

Bouchard, Richard J is an individual health care provider with primary practice located at 813 Broadway , South Portland ME 04106. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bouchard, Richard J can be contacted via phone (207) 650-6450.

Contact Information

Primary practice address
813 Broadway South Portland ME 04106
Phone: (207) 650-6450
Fax: (207) 650-6450
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LC4009 Maine

Profile Details

NPI number 1497791164
LBN Legal business name Bouchard, Richard J
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Jan 19th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497791164 NPPES
Maine Other 037017 ANTHEM BC/BS PROVIDER NO.
Maine MEDICAID 264990099 ANTHEM BC/BS PROVIDER NO.

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