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Individual
MS. CHEVELLE MARIE BOURDON
Active
Individual
MS. CHEVELLE MARIE BOURDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW 99121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
LCSW99121
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99121
LCSW
CA
Enumeration date
08/06/2012
Last updated
06/02/2026
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