Emmadora Boutcher
Individual provider Active NPI Clinical Social Worker · Dummerston, VT
NPI 1396308409 · NPPES record last updated May 18, 2026
Key facts
- NPI
- 1396308409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 089.0137076 (VT)
- Practice address
- 62 Riverside Dr
Dummerston, VT 05301-8928 - Phone
- (802) 822-2520
- NPI assigned
- Apr 16, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122182 | MA | MD | Clinical Social Worker |
| 089.0137076 | VT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Weaving Waters LLC | Current | Accepting new patients | |
| Blue Square Counseling and Wellness Center, PLLC | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089.0137076 | VT | Yes |
| Clinical Social Worker | 1041C0700X | 122182 | MA |
Addresses
Primary practice location
62 Riverside Dr
Dummerston, VT 05301-8928
Mailing address
62 Riverside Dr
Dummerston, VT 05301-8928
Phone (802) 822-2520
Other providers in Dummerston, VT
- Ariana Ameli
- Myles C Arendtson
- Arrivals, LLC
- Kennie Bassey
- Wendy Ellen Baxter
- Rebecca Lauren Butler
- Margeaux Cannon
- Rebbecca Marie Castillo
- Rachel Christine Conrad
- Dominic Mario Denning
All providers in Dummerston, VT · Clinical Social Worker in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.