Jenna Boutilier

Primary specialty

SpecialistTaxonomy code 174400000X

License

2079090261 Issued in NY

Practice address

8282 Willett Pkwy
Baldwinsville, NY 13027-1306

Phone

(315) 857-0800

NPI assigned

Aug 27, 2026

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1013825587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 FAR REACH DR",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130271511",
            "telephone_number": "315-720-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8282 WILLETT PKWY",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130271306",
            "telephone_number": "315-857-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTILIER",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "2079090261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Blume
• Tracy Lynn Boisey
• Kimberly Ann Bono
• Lynda L. Bookman
• Jennifer Lyn Bordonaro-Benson, LCSW
• Melissa Renee Bouvia
• Joanne L Bowen, D.C.
• Britany Brancheau, LMSW
• Jill Braun
• Leanna Brier

• All providers in Baldwinsville, NY
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.