Individual provider Active NPI

Theresa McCay Boutross, LCSW, CADC

  • Clinical Social Worker
  • Dunedin, FL
National Provider Identifier
1598272585
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW20739 Issued in FL
Practice address
646 Wood St
Dunedin, FL 34698-7151
Phone
(312) 610-0694
NPI assigned
Dec 29, 2017
Last updated
Dec 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC23697 ME
Clinical Social Worker 1041C0700X SW20739 FL Primary
Clinical Social Worker 1041C0700X 7468 TN
Clinical Social Worker 1041C0700X 149-009834 IL

Addresses

Primary practice location

646 Wood St
Dunedin, FL 34698-7151

Mailing address

646 Wood St
Dunedin, FL 34698-7151
Phone (312) 610-0694

Other practice location 1

91 Abbottsford Rd
Winnetka, IL 60093-4264
Phone (312) 610-0694

Other names 1

  • Theresa Marie McCay Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7468TNMDMental Health Counselor
SW20739FLMDClinical Social Worker
149-009834ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1598272585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 WOOD ST",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346987151",
            "telephone_number": "312-610-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 WOOD ST",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346987151",
            "telephone_number": "312-610-0694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Abbottsford Rd",
            "address_purpose": "LOCATION",
            "city": "Winnetka",
            "state": "IL",
            "postal_code": "600934264",
            "country_code": "US",
            "telephone_number": "312-610-0694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUTROSS",
        "first_name": "THERESA",
        "middle_name": "MCCAY",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-29",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC23697",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20739",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7468",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-009834",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "MCCAY",
            "middle_name": "MARIE",
            "credential": "LCSW, CADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dunedin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; 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.