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KELLY E. BOURDAGE ASW NPI 1487145462


NPI Information

NPI: 1487145462
Provider Name: KELLY E. BOURDAGE, ASW
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

Address:
3517 CAMINO DEL RIO S STE 407
SAN DIEGO, CA
ZIP 92108
Phone: (619) 955-8905
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Kelly E. Bourdage, ASW is a clinical social worker in San Diego, CA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. Kelly E. Bourdage, ASW NPI is 1487145462. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3517 CAMINO DEL RIO S STE 407
SAN DIEGO, CA
ZIP 92108-028
Phone: (619) 955-8905

The enumeration date for this NPI number is 5/24/2018 and was last updated on 11/6/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171M00000XCase Manager/Care CoordinatorNo
21041C0700XSocial WorkerClinical96746CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1907812514400OTHERWISCONSINTHE ALLIANCE FIRST HEALTH NETWORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.