Mindy A Knight Bouchard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC12108 Issued in ME

Practice address

225 Commercial St Ste 300
Portland, ME 04101-6606

Phone

(207) 768-0039

Fax

(207) 761-0265

NPI assigned

Jun 11, 2007

Last updated

Feb 20, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mindy A Knight Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Central Aroostook Psychiatric Services LLC

  • Psychiatry Physician
  • Presque Isle, ME
  • NPI 1831368042
  NPD (past)
• Micmac Health Department

  • Community Health Clinic/Center
  • Presque Isle, ME
  • NPI 1881232346
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1447454947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 COMMERCIAL ST. SUITE 300",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-768-0039",
            "fax_number": "207-761-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 COMMERCIAL ST STE 300",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041016606",
            "telephone_number": "207-768-0039",
            "fax_number": "207-761-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT BOUCHARD",
        "first_name": "MINDY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC12108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264890099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINDY",
            "last_name": "KNIGHT",
            "middle_name": "A",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Klotz, PA
• Lisa Klusmeier, LCSW
• Jordan Knab, LCPC-CC
• Laura Olivia Knapik, DO
• Laurel Marie Knapp, D.O.
• Ali Knight
• Carleen Knight, NP
• Alisa J Knop, P.T.
• David T Knop, PT
• Kristen Knopp, NP-C

• Clinical Social Worker in Portland, ME
• Providers in Portland, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.