Provider Demographics
NPI:1538310404
Name:BOUGAS, JAMES E
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:BOUGAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 FAIR OAK DR
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-2654
Mailing Address - Country:US
Mailing Address - Phone:508-896-3787
Mailing Address - Fax:
Practice Address - Street 1:50 LONG POND DR
Practice Address - Street 2:
Practice Address - City:S YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-4180
Practice Address - Country:US
Practice Address - Phone:508-760-1475
Practice Address - Fax:508-760-3719
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health