MS. ELLEN ANN BOURNE MSW
NPI 1669619714
Counselor - Mental Health in Clearlake, CA
Active since January 12, 2009
About Ms. Ellen Ann Bourne Msw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. ELLEN ANN BOURNE MSW (NPI 1669619714) is an individual mental health provider in Clearlake, California and active in the NPI registry since January 2009.
NPPES Registry Identity
NPI1669619714
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. ELLEN ANN BOURNECredential: MSW
Location Address7000 S CENTER DR, BClearlake, CA 95422-8131
Mailing Address7000 S Center Dr, BClearlake, CA 95422-8131 · (707) 994-7090 · Fax (707) 994-7092
Phone(707) 994-7090
Fax(707) 994-7092
Sole ProprietorNo
Enumeration DateJanuary 12, 2009
Last NPPES UpdateMay 19, 2011
✔ NPI 1669619714 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
7000 S CENTER DR, Clearlake, CA 95422
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Counselor (Addiction (Substance Use Disorder))
7000 S CENTER DR
CLEARLAKE, CA 95422
CLEARLAKE, CA 95422
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1669619714, enumerated as an "individual" on January 12, 2009.
The provider is located at 7000 S CENTER DR B CLEARLAKE, CA 95422 and the phone number is (707) 994-7090.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
