Individual provider · Type 1 NPI

Shelly Bourquin, LCSW

Clinical Social Worker · Waukesha, WI

NPI number 1689108250 Active

Practice location

514 Riverview Ave
Waukesha, WI 53188-3631

Call (262) 548-7666 Map

Mailing address

1741 Kettle Cove Ct
Hartland, WI 53029-9365

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000X130442 (WI)
Clinical Social Worker Primary 1041C0700X9229 (WI)

Clinical Social Worker: 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 interpers…

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About NPI 1689108250

Shelly Bourquin, LCSW's National Provider Identifier is 1689108250, issued on Apr 20, 2017. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Waukesha, WI. The record was last updated on May 21, 2025.