Chastidy Boutin

Primary specialty

Social WorkerTaxonomy code 104100000X

License

CSW009362 Issued in GA

Practice address

1817 Green Cir
Valdosta, GA 31602-2885

Phone

(229) 244-9688

NPI assigned

Nov 15, 2021

Last updated

Jan 7, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• The Grounded Mind Therapy and Consultation, L.L.C.

  dba Chastidy Boutin

  • Clinical Social Worker
  • Valdosta, GA
  • NPI 1548079700
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1447916333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 GREEN CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022885",
            "telephone_number": "229-244-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 GREEN CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022885",
            "telephone_number": "229-244-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTIN",
        "first_name": "CHASTIDY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "CSW009362",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Mark Booth, AA
• Mildred Itaska Borowski, LPC
• Morgan Brooke Boruff, OTR/L
• Elizabeth Ann Bostic, FNP-C
• Rebecca S Bourquine
• Anissa Bowers
• Emmett W Bowers, M.D.
• Carrie P. Bowling, PA-C
• Shawna Yvette Bowman
• Raven Boyd, R.N.

• Social Worker in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.