- Practice location
- 17 School St, Randolph, ME 04346-5143
- Phone
- 207-588-2699
- Fax
- —
- Last updated
- August 21, 2024
Lacey Bourgoin is a Specialist/Technologist, Speech-Language Assistant based in Randolph, ME. Lacey Bourgoin practices in Randolph, ME and has the professional credentials of SLP-A. The NPI Number for Lacey Bourgoin is 1528467792 and holds a License No. BH001153 (PA). The current practice location address for Lacey Bourgoin is 17 School St, Randolph, ME 04346-5143 and can be reached out via phone at 207-588-2699.
Provider Profile Details
- NPI Number
- 1528467792
- Provider Name
- Lacey Bourgoin
- Credential
- SLP-A
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 17 School St, Randolph, ME 04346-5143
- Phone Number
- 207-588-2699
- Primary Taxonomy
- Specialist/Technologist, Speech-Language Assistant · 2355S0801X
- Sole Proprietor
- No
- Provider Enumeration Date
- August 14, 2014
- Last Update Date
- August 21, 2024
- Certification Date
- August 21, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 17 School St
Randolph, ME 04346-5143 - City
- Randolph
- State
- Maine
- Zip
- 04346-5143
- Phone Number
- 207-588-2699
Provider Business Mailing Address Details
- Address
- 17 School St
Randolph, ME 04346-5143 - City
- Randolph
- State
- ME
- Zip
- 04346-5143
License Information
- License Number (1)
- BH001153
- License State (1)
- PA
- Taxonomy (1)
- Counselor, Mental Health · 101YM0800X
- Taxonomy (2)
- Specialist/Technologist, Speech-Language Assistant · 2355S0801X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Lacey Bourgoin, SLP-A?
The NPI number of Lacey Bourgoin, SLP-A is 1528467792. It was assigned on August 14, 2014 and is currently active in the NPPES registry.
What is the specialty of Lacey Bourgoin, SLP-A?
Lacey Bourgoin, SLP-A is registered under the primary taxonomy Specialist/Technologist, Speech-Language Assistant (code 2355S0801X), licensed in PA under license number BH001153.
Where does Lacey Bourgoin, SLP-A practice?
The practice location is 17 School St, Randolph, ME 04346-5143. The office can be reached at 207-588-2699 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1528467792 directly on the NPPES registry website.