Active NPI
Kaitlyn Brianna Bouton, LMSW-CC
- Clinical Social Worker
- Bangor, ME
National Provider Identifier
1992535892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- MC23677
- Practice address
- 40 Summer St
Bangor, ME 04401-7144 - Phone
- (207) 945-4240
- NPI assigned
- Aug 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | MC23677 | ME | Primary |
Addresses
Primary practice location
40 Summer St
Bangor, ME 04401-7144
Mailing address
PO Box 556
Guilford, ME 04443-0556
Phone (207) 343-1501
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
| License | State | Type | Specialty |
|---|---|---|---|
| MC23677 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751846400000",
"number": "1992535892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 556",
"city": "GUILFORD",
"state": "ME",
"postal_code": "044430556",
"telephone_number": "207-343-1501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 SUMMER ST",
"city": "BANGOR",
"state": "ME",
"postal_code": "044017144",
"telephone_number": "207-945-4240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUTON",
"first_name": "KAITLYN",
"middle_name": "BRIANNA",
"name_prefix": "Mrs.",
"credential": "LMSW-CC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-05",
"last_updated": "2025-07-07",
"certification_date": "2025-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "MC23677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.