Individual provider Active NPI

Richard J Bouchard Jr., LCSW

  • Clinical Social Worker
  • Scarborough, ME
National Provider Identifier
1497791164
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC4009 Issued in ME
Practice address
605 US Route 1 Ste 20
Scarborough, ME 04074-7675
Phone
(207) 650-6450
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC4009 ME Primary

Addresses

Primary practice location

605 US Route 1 Ste 20
Scarborough, ME 04074-7675

Mailing address

PO Box 1933
Portland, ME 04104-1933
Phone (207) 650-6450

Other identifiers 2

IdentifierTypeStateIssuer
264990099MedicaidME
037017OtherMEANTHEM BC/BS PROVIDER NO.

Other names 1

  • Rick Bouchard Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20040629001079 ME Practitioner - Clinical Social Worker 2961488960 Practice locations: Portland, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

615 Congress St
Suite 311
Portland, ME 04101-5354
Phone (207) 650-6450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC4009MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Counseling, Inc. Past Accepting new patients
Sweetser Past Accepting new patients
Art of Awareness, Inc. Clinical Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1497791164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1933",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041041933",
            "telephone_number": "207-650-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 US ROUTE 1 STE 20",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747675",
            "telephone_number": "207-650-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC4009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264990099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS PROVIDER NO.",
            "identifier": "037017",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICK",
            "last_name": "BOUCHARD",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.