Provider Demographics
NPI:1598017642
Name:BOUCHARD, CELINE MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CELINE
Middle Name:MARIE
Last Name:BOUCHARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:492 ROUTE 57 WEST
Mailing Address - Street 2:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-4411
Mailing Address - Country:US
Mailing Address - Phone:908-689-1000
Mailing Address - Fax:908-689-4529
Practice Address - Street 1:492 ROUTE 57 WEST
Practice Address - Street 2:FAMILY GUIDANCE CENTER OF WARREN COUNTY
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-4411
Practice Address - Country:US
Practice Address - Phone:908-689-1000
Practice Address - Fax:908-689-4529
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053729001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical