| Bianca Boucher Lcsw Pllc | |
|
6006 Number Four Rd Lowville NY 13367-3309 | |
| (315) 220-9525 | |
| Not Available |
| Full Name | Bianca Boucher Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 6006 Number Four Rd, Lowville, New York |
| Authorized Official Name and Position | Bianca Boucher (SOLE MEMBER) |
| Authorized Official Contact | 3157670865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bianca Boucher Lcsw Pllc 6006 Number Four Rd Lowville NY 13367-3309 Ph: (315) 220-9525 | Bianca Boucher Lcsw Pllc 6006 Number Four Rd Lowville NY 13367-3309 Ph: (315) 220-9525 |
| NPI Number | 1235990508 |
|---|---|
| Provider Enumeration Date | 01/23/2024 |
| Last Update Date | 06/18/2024 |
| Certification Date | 06/18/2024 |
| Medicare PECOS PAC ID | 2062858970 |
|---|---|
| Medicare Enrollment ID | O20240314001021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235990508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Bianca J Boucher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104114479 PECOS PAC ID: 4981903796 Enrollment ID: I20160429000360 |
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