Kristen Breault-Bolio, MS, LCMHC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

068.0111093 Issued in VT

Practice address

31 Elmwood Ave
Burlington, VT 05401-4347

Phone

(802) 864-7423

Fax

(802) 660-0576

NPI assigned

Sep 10, 2015

Sex

Female

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Feb 29, 2024 through Mar 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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 and National Provider Directory roles.

• KBB Psychotherapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Williston, VT
  • NPI 1467132530
  NPD Authorized official
• KBB Counseling PLLC

  • Mental Health Counselor
  • Pittsfield, MA
  • NPI 1417746611

  Mental Health

  NPD Authorized official
• Spectrum, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Burlington, VT
  • NPI 1164556726

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689984000000",
    "number": "1962870758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 TALCOTT RD STE 206",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054952075",
            "telephone_number": "802-944-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 ELMWOOD AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014347",
            "telephone_number": "802-864-7423",
            "fax_number": "802-660-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAULT-BOLIO",
        "first_name": "KRISTEN",
        "credential": "MS, LCMHC, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2023-07-22",
        "certification_date": "2023-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "151.0127541",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0111093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Marlowe Branagan
• Richard Frank Branda, M.D.
• Melissa K Brandes, M.D.
• Jason Ethan Brant, MD
• Jason Douglas Brazelton, M.D.
• Jenny M Breckenridge, P.T.
• Joseph Breidenstein Jr.
• Judith Joann Breitmeyer, M.A.,M.A.
• Christopher M Brennan, MD, PHD
• Eli Brennan, MD

• All providers in Burlington, VT
• Mental Health Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.