Kristen Breault, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC16403 Issued in ME

Practice address

180 US Route 1
Scarborough, ME 04074-9073

Phone

(207) 289-3553

NPI assigned

Oct 2, 2014

Last updated

Jul 21, 2022By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1558764787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 US ROUTE ONE",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749041",
            "telephone_number": "207-289-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749073",
            "telephone_number": "207-289-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAULT",
        "first_name": "KRISTEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC14918",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC16403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Bragdon
• Benjamin Frederick Branch, DO
• Lindsey Joan Brangwynne, D.M.D.
• Mark Braun, MD
• Yaneysy Bravo, PHARMD
• Emily Lavoie Brennan, APRN-FNP
• Hollie Rae Brewer-Cushman, LCSW
• Anna Marie Brewer, RN,MSN,APRN,FNP-C
• Kate Brewer
• Daniel Robert Briggi, MD

• Clinical Social Worker in Scarborough, ME
• Providers in Scarborough, 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 Jul 21, 2022; 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.