Jenna Boulette, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13084 Issued in CT

Practice address

140 N Frontage Rd
Mansfield Center, CT 06250-1648

Phone

(860) 456-2261

Fax

(860) 430-1357

NPI assigned

Aug 16, 2021

Last updated

Mar 5, 2026By the provider in NPPES

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

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Services IncGroup PAC ID 8426042698, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• United Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayville, CT
  • NPI 1063413011
  Medicare reassignment Care Compare group NPD
• Stokes Counseling Services LLC

  • Professional Counselor
  • Naugatuck, CT
  • NPI 1134541469

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1053086652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 N MAIN ST",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "062412170",
            "telephone_number": "860-774-2020",
            "fax_number": "860-774-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N FRONTAGE RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501648",
            "telephone_number": "860-456-2261",
            "fax_number": "860-430-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULETTE",
        "first_name": "JENNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "13084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Marie Blayer, LCSW, MDIV
• Jamie Leale Blodgett, LCSW
• Andrew Botelho, LPC-A
• Angie Botero Castro, LCSW
• Osman Botonjic
• Kaitlyn Ann Bowyer, LMSW
• Stella Bragoni
• Zachary Brown, LMSW
• James Buccini, LMSW
• Linda Z Buchanan, PT, DPT

• Clinical Social Worker in Mansfield Center, CT
• Providers in Mansfield Center, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.