Justin P Bouchard, PRSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

194.0000018 Issued in VT

Practice address

79 Court St
Middlebury, VT 05753-1406

Phone

(802) 388-4249

NPI assigned

Aug 31, 2026

Last updated

Aug 31, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1700794658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 COURT ST",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057531406",
            "telephone_number": "802-388-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 COURT ST",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057531406",
            "telephone_number": "802-388-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "JUSTIN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PRSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "VT",
            "license": "194.0000018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah E Binshadler
• Paula M Birdsall, RD
• Caitlin Bone, D.C.
• Sally Eleanor Borden
• Jacqueline M Botala
• Charles Raymond Bowen, DMD
• Scott Martin Bowen, DMD MD MPH
• Philip B. Bowman, MA
• Mary Ann Dattilo Boyd, LICSW
• Johana Kashiwa Brakeley, M.D.

• Peer Specialist in Middlebury, VT
• Providers in Middlebury, VT by specialty
• Peer Specialist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; 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.