Matthew I Bouchard, LICSW
Social Worker, Clinical in Burlington, Vermont
1174106884- Practice location
- 128 Lakeside Ave Ste 260, Burlington, VT 05401-5911
- Phone
- 802-657-7087
- Fax
- 802-657-7078
- Last updated
- April 30, 2021
Matthew Ian Bouchard is a Social Worker, Clinical based in Burlington, VT. Matthew Ian Bouchard practices in Burlington, VT and has the professional credentials of LICSW. The NPI Number for Matthew Ian Bouchard is 1174106884 and holds a License No. 089.0134397 (VT). The current practice location address for Matthew Ian Bouchard is 128 Lakeside Ave Ste 260, Burlington, VT 05401-5911 and can be reached out via phone at 802-657-7087 and via fax at 802-657-7078.
Provider Profile Details
- NPI Number
- 1174106884
- Provider Name
- Matthew Ian Bouchard
- Credential
- LICSW
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 128 Lakeside Ave Ste 260, Burlington, VT 05401-5911
- Phone Number
- 802-657-7087
- Fax Number
- 802-657-7078
- Primary Taxonomy
- Social Worker, Clinical · 1041C0700X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 30, 2021
- Last Update Date
- April 30, 2021
- Certification Date
- January 14, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 128 Lakeside Ave Ste 260
Burlington, VT 05401-5911 - City
- Burlington
- State
- Vermont
- Zip
- 05401-5911
- Phone Number
- 802-657-7087
- Fax Number
- 802-657-7078
Provider Business Mailing Address Details
- Address
- 128 Lakeside Ave Ste 260
Burlington, VT 05401-5911 - City
- Burlington
- State
- VT
- Zip
- 05401-5911
- Phone Number
- 802-657-7090
- Fax Number
- 802-657-7078
License Information
- License Number
- 089.0134397
- License State
- VT
- Taxonomy
- Social Worker, Clinical · 1041C0700X · 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 Matthew I Bouchard, LICSW?
The NPI number of Matthew I Bouchard, LICSW is 1174106884. It was assigned on April 30, 2021 and is currently active in the NPPES registry.
What is the specialty of Matthew I Bouchard, LICSW?
Matthew I Bouchard, LICSW is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X), licensed in VT under license number 089.0134397.
Where does Matthew I Bouchard, LICSW practice?
The practice location is 128 Lakeside Ave Ste 260, Burlington, VT 05401-5911. The office can be reached at 802-657-7087 (phone) or 802-657-7078 (fax).
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 1174106884 directly on the NPPES registry website.