Active NPI
Kimberly L Abram, LCSW
- Social Worker
- Bozrah, CT
National Provider Identifier
1407005341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 46 Lebanon Rd
Bozrah, CT 06334-1116 - Phone
- (860) 788-5462
- NPI assigned
- Sep 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
46 Lebanon Rd
Bozrah, CT 06334-1116
Mailing address
44 Maclyn Dr
Colchester, CT 06415-2041
Phone (860) 966-1292
Other names 1
- Kim L Boutin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 15, 2025 through Jan 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7869 | CT | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738627200000",
"number": "1407005341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 MACLYN DR",
"city": "COLCHESTER",
"state": "CT",
"postal_code": "064152041",
"telephone_number": "860-966-1292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 LEBANON RD",
"city": "BOZRAH",
"state": "CT",
"postal_code": "063341116",
"telephone_number": "860-788-5462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABRAM",
"first_name": "KIMBERLY",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-16",
"last_updated": "2025-02-04",
"certification_date": "2025-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIM",
"last_name": "BOUTIN",
"middle_name": "L",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bozrah, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.