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ETHAN EMERY BOURQUE
NPI 1376321000
Counselor in Wilton, CT

Active since September 14, 2023
396 DANBURY RD STE 2A, WILTON, CT 06897(203) 202-7654 Get Directions Write a Review

NPPES record last updated: September 14, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ethan Emery Bourque NPPES

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

ETHAN EMERY BOURQUE (NPI 1376321000) is an individual counselor in Wilton, Connecticut and active in the NPI registry since September 2023.

NPPES Registry Identity

NPI1376321000
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameETHAN EMERY BOURQUE
Location Address396 DANBURY RD STE 2AWilton, CT 06897-2024
Mailing Address396 Danbury Rd Ste 2aWilton, CT 06897-2024
Phone(203) 202-7654
Sole ProprietorYes
Enumeration DateSeptember 14, 2023
NPPES CertifiedSeptember 14, 2023
✔ NPI 1376321000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
396 DANBURY RD STE 2A, Wilton, CT 06897
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

MS. MARYSA YVONNE WALSH OTR
Occupational Therapist
396 DANBURY RD STE 2A
WILTON, CT 06897
Western Connecticut Planning Region (203) 529-1700
BRENNA NATALIA DESTEFANO MSOT, OTR/L
Occupational Therapist
396 DANBURY RD STE 2A
WILTON, CT 06897
Western Connecticut Planning Region (203) 422-2193
DR. SHARON MARIA MCCLOSKEY EDD, MBA, OT/L, CPT
Occupational Therapist
396 DANBURY RD STE 2A
WILTON, CT 06897
Western Connecticut Planning Region (203) 202-7654
ERICA PALUMBO MA, ED.S.
Psychologist (School)
396 DANBURY RD STE 2A
WILTON, CT 06897
Western Connecticut Planning Region (203) 529-1700
ALEXANDRA DEGIACOMO OTR
Occupational Therapist
396 DANBURY RD STE 2A
WILTON, CT 06897
Western Connecticut Planning Region (203) 422-2193

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 Ethan Bourque's NPI number?

The NPI number for Ethan Bourque is 1376321000. It was assigned to this individual provider in the NPPES registry on September 14, 2023.

Where is Ethan Bourque located?

Ethan Bourque practices at 396 Danbury Rd Ste 2A, Wilton, CT 06897. The listed phone number is (203) 202-7654.

What is Ethan Bourque's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Ethan Bourque was last updated on September 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.