- Practice location
- 59 Davis St, Old Town, ME 04468-1337
- Phone
- 323-898-9622
- Fax
- —
- Last updated
- February 27, 2026
Jeffrey Loberiano Boucher is a Nurse Practitioner, Psych/Mental Health based in Old Town, ME. Jeffrey Loberiano Boucher practices in Old Town, ME and has the professional credentials of PMHNP. The NPI Number for Jeffrey Loberiano Boucher is 1124973938 and holds a License No. 95038702 (CA). The current practice location address for Jeffrey Loberiano Boucher is 59 Davis St, Old Town, ME 04468-1337 and can be reached out via phone at 323-898-9622.
Provider Profile Details
- NPI Number
- 1124973938
- Provider Name
- Jeffrey Loberiano Boucher
- Credential
- PMHNP
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 59 Davis St, Old Town, ME 04468-1337
- Phone Number
- 323-898-9622
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Sole Proprietor
- No
- Provider Enumeration Date
- February 27, 2026
- Last Update Date
- February 27, 2026
- Certification Date
- February 27, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 59 Davis St
Old Town, ME 04468-1337 - City
- Old Town
- State
- Maine
- Zip
- 04468-1337
- Phone Number
- 323-898-9622
Provider Business Mailing Address Details
- Address
- 59 Davis St
Old Town, ME 04468-1337 - City
- Old Town
- State
- ME
- Zip
- 04468-1337
- Phone Number
- 323-898-9622
License Information
- License Number
- 95038702
- License State
- CA
- Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Jeffrey L Boucher, PMHNP?
The NPI number of Jeffrey L Boucher, PMHNP is 1124973938. It was assigned on February 27, 2026 and is currently active in the NPPES registry.
What is the specialty of Jeffrey L Boucher, PMHNP?
Jeffrey L Boucher, PMHNP is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X), licensed in CA under license number 95038702.
Where does Jeffrey L Boucher, PMHNP practice?
The practice location is 59 Davis St, Old Town, ME 04468-1337. The office can be reached at 323-898-9622 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1124973938 directly on the NPPES registry website.