Kristen Beaudouin, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121226 Issued in MA

Practice address

157 Green St
Jamaica Plain, MA 02130-2667

Phone

(617) 390-1259

NPI assigned

Apr 30, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Columbia University College of Physicians and Surgeons, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arbour IncGroup PAC ID 6800975574, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Arbour Inc

  • Psychiatry Physician
  • Boston, MA
  • NPI 1770766529
  Medicare reassignment Care Compare group NPD
• Arbour Inc

  • Psychiatric Hospital
  • Boston, MA
  • NPI 1821068818
  NPD

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1073923918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 GREEN ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302667",
            "telephone_number": "617-390-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 GREEN ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302667",
            "telephone_number": "617-390-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUDOUIN",
        "first_name": "KRISTEN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085024",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Batista, MD
• Mark Stephen Bauer, M.D.
• Michelle Baumann, LCSW
• Lenny Manuel Bautista
• Baycove
• Stefan M Becker, LMHC
• Selam Bekele, RDH
• Dawn Belkin Martinez, PHD LICSW
• Carol Lynn Bell, MSW
• Megan Benders

• Clinical Social Worker in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.