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RENEE DEBORAH THERRIEN BOUCHAREB
NPI 1215612189
Speech-Language Pathologist in Lino Lakes, MN

Active since June 19, 2023
6776 LAKE DR STE 220, LINO LAKES, MN 55014(651) 784-7007 Get Directions Write a Review

NPPES record last updated: June 19, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Renee Deborah Therrien Bouchareb NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RENEE DEBORAH THERRIEN BOUCHAREB (NPI 1215612189) is an individual speech-language pathologist provider in Lino Lakes, Minnesota and active in the NPI registry since June 2023.

NPPES Registry Identity

NPI1215612189
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameRENEE DEBORAH THERRIEN BOUCHAREB
Location Address6776 LAKE DR STE 220Lino Lakes, MN 55014-1192
Mailing Address6776 Lake Dr Ste 220Lino Lakes, MN 55014-1192 · (651) 784-7007
Phone(651) 784-7007
Sole ProprietorNo
Enumeration DateJune 19, 2023
NPPES CertifiedJune 19, 2023
✔ NPI 1215612189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
6776 LAKE DR STE 220, Lino Lakes, MN 55014
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Other Names 1

Former Name (1)Renee Deborah Therrien

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Renee Deborah Therrien Bouchareb is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Renee Bouchareb reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Advance Speech Therapy, LLC
Same address
Speech-Language Pathologist
6776 LAKE DR, 220
Lino Lakes, MN 55014
  • Reassigned Medicare billing, Minnesota enrollment
  • 15 clinicians in this Medicare group
NPI 1215144654 (651) 784-7007

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN ELIZABETH ROSAUER GRAY OTR/L
Occupational Therapist (Pediatrics)
6776 LAKE DR STE 220
LINO LAKES, MN 55014
Anoka County (651) 784-7007
PAULA JEAN METLING OT/L
Occupational Therapist
6776 LAKE DR STE 220
LINO LAKES, MN 55014
Anoka County (651) 784-7007
KAELYN LAYELL ISAACSON
Speech-Language Pathologist
6776 LAKE DR STE 220
LINO LAKES, MN 55014
Anoka County (651) 784-7007
KATELYN MARIE RASCHER OTR/L
Occupational Therapist (Pediatrics)
6776 LAKE DR STE 220
LINO LAKES, MN 55014
Anoka County (651) 784-7007
AMY NOELLE PETERSON PT
Physical Therapist
6776 LAKE DR STE 220
LINO LAKES, MN 55014
Anoka County (651) 784-7007
ANGIE THOMPSON
Speech-Language Pathologist
6776 LAKE DR STE 220
LINO LAKES, MN 55014
Anoka County (651) 784-7007
JOYCE MARIE HENNES OTR/L
Occupational Therapist
6776 LAKE DR STE 220
LINO LAKES, MN 55014
Anoka County (651) 784-7007
KATE OLIVIA HANSON MA, CF-SLP
Speech-Language Pathologist
6776 LAKE DR STE 220
LINO LAKES, MN 55014
Anoka County (651) 784-7007

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Renee Bouchareb's NPI number?

The NPI number for Renee Bouchareb is 1215612189. It was assigned to this individual provider in the NPPES registry on June 19, 2023. The provider is also known as Renee Deborah Therrien.

Where is Renee Bouchareb located?

Renee Bouchareb practices at 6776 Lake Dr Ste 220, Lino Lakes, MN 55014. The listed phone number is (651) 784-7007.

What is Renee Bouchareb's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Renee Bouchareb enrolled in Medicare?

Yes. Renee Bouchareb is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Renee Bouchareb's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Renee Bouchareb reassigns Medicare benefits to Advance Speech Therapy, LLC (Lino Lakes, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Renee Bouchareb's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Renee Bouchareb was last updated on June 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.