MCKENZIE BOURQUE
NPI 1417634866
Psychologist - Clinical in Philadelphia, PA

Q: What is Mckenzie Bourque's NPI number?

The NPI number for Mckenzie Bourque is 1417634866. It was assigned to this individual provider in the NPPES registry on June 28, 2023.

Q: What is Mckenzie Bourque's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Mckenzie Bourque was last updated on June 28, 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.

Active since June 28, 2023

3550 MARKET ST, PHILADELPHIA, PA 19104(267) 624-3493 Get Directions Write a Review

NPPES record last updated: June 28, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mckenzie Bourque NPPES

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

MCKENZIE BOURQUE (NPI 1417634866) is an individual clinical provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (PS019921) and active in the NPI registry since June 2023. She maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1417634866

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameMCKENZIE BOURQUE

Location Address3550 MARKET STPhiladelphia, PA 19104-3329

Mailing Address2226 S Mildred StPhiladelphia, PA 19148-3110 · (518) 207-5432

Phone(267) 624-3493

Sole ProprietorNo

Enumeration DateJune 28, 2023

NPPES CertifiedJune 28, 2023

✔ NPI 1417634866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in PA · PS019921

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

3550 MARKET ST, Philadelphia, PA 19104

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Secondary Practice Location 1

Location 1225 S Cobbs Creek PkwyPhiladelphia, PA 19139-3723 · Phone (215) 476-2223

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.

MRS. LEIGH ANN ROLA PA-C

Physician Assistant

3550 MARKET ST, 2ND FLOOR - PEDIATRIC DERMATOLOGY
PHILADELPHIA, PA 19104

Philadelphia County (215) 590-2169

DR. ELIZABETH ELLIOTT MD

Pediatrics

3550 MARKET ST, 5TH FLOOR
PHILADELPHIA, PA 19104

Philadelphia County (215) 590-3000

DR. LISA BIGGS MD

Pediatrics

3550 MARKET ST
PHILADELPHIA, PA 19104

Philadelphia County (215) 590-3000

ANGELA MARIE BURNS MSW

Social Worker

3550 MARKET ST
PHILADELPHIA, PA 19104

Philadelphia County (215) 590-2956

DR. TRUDE HAECKER MD

Pediatrics

3550 MARKET ST, 5TH FLOOR
PHILADELPHIA, PA 19104

Philadelphia County (215) 590-3000

PENNSYLVANIA DENTAL GROUP LTD.

Dentist (General Practice)

3550 MARKET ST
PHILADELPHIA, PA 19104

Philadelphia County (215) 387-0883

KAITLIN GOY

Nurse Practitioner (Psychiatric/Mental Health)

3550 MARKET ST
PHILADELPHIA, PA 19104

Philadelphia County (215) 590-1000

CHRISTINE FORKE CPNP

Nurse Practitioner (Pediatrics)

3550 MARKET ST, CHOP/ADOLESCENT MED, 4TH FLOOR
PHILADELPHIA, PA 19104

Philadelphia County (215) 590-3537

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 Mckenzie Bourque's NPI number?

The NPI number for Mckenzie Bourque is 1417634866. It was assigned to this individual provider in the NPPES registry on June 28, 2023.

Where is Mckenzie Bourque located?

Mckenzie Bourque practices at 3550 Market St, Philadelphia, PA 19104. The listed phone number is (267) 624-3493.

What is Mckenzie Bourque's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Mckenzie Bourque was last updated on June 28, 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.