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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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