Bourque, Melissa R
Bourque, Melissa R is an individual health care provider with primary practice located at 141 E Main St Fl 1 , Waterbury CT 06702-2310. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bourque, Melissa R can be contacted via phone (203) 574-9000.Contact Information
Primary practice address
141 E Main St Fl 1
Waterbury CT 06702-2310
Phone: (203) 574-9000
Fax: (203) 574-9006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 10219 | Connecticut |
Profile Details
| NPI number | 1821472770 |
|---|---|
| LBN Legal business name | Bourque, Melissa R |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 9th, 2015 |
| Last updated | May 7th, 2018 - about 8 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 | 1821472770 | NPPES |
| Connecticut | Other | 060669107 | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | Other | NOT ELIGIBLE | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | Other | 060669107 | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | Other | 060669107 | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | Other | D339209 | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | Other | PENDING | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | Other | 060669107 | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | Other | 060669107 | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | Other | 13671798 | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | MEDICAID | 008062581 | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | Other | 060669107 | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| Connecticut | Other | PENDING | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
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