KAITLYN BOUDREAU (LCSW) – Social Worker, NPI 1033684568

KAITLYN BOUDREAU (LCSW) is a healthcare provider. based in Waterville, Maine. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. LC19561 (ME). The NPI Number for KAITLYN BOUDREAU (LCSW) is 1033684568

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
KAITLYN BOUDREAU (LCSW)
NPI
1033684568
Phone
(207) 873-2136
Address
67 EUSTIS PKWY
Enumeration Date
11 October 2018
Last Update Date
2 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2078732136
Graduation Year
2018 (8 years ago)
PAC ID
2163838632
Group Practice PAC ID
7113829383
Professional Enrollment ID
I20210308001633
Address ID
ME049015173WA67XXXPKWY300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,104 CLINICAL SOCIAL WORKER in ME

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Provider Addresses for KAITLYN BOUDREAU (LCSW)

  • 67, Eustis Parkway, Waterville, Kennebec County, Maine, 04901, United States

    WATERVILLE, ME 049015173

    Phone: (207) 873-2136

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-03-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210308001633IClinical Social WorkerMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 04901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113829383View full group profile
NameSpecialtyState
-ME
Physician AssistantME
Clinical Social WorkerME
P S Y C H I A T R YME
-ME
Clinical Social WorkerME
-ME
Nurse PractitionerME
Clinical Social WorkerME
Clinical Social WorkerME

Reviews

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Frequently asked questions

Can I use this page to confirm KAITLYN BOUDREAU (LCSW)'s NPI?
Yes. KAITLYN BOUDREAU (LCSW) is listed with NPI 1033684568 in the public NPI dataset.
Does the file indicate KAITLYN BOUDREAU (LCSW) is practicing under active NPI?
Directory data currently reports KAITLYN BOUDREAU (LCSW) as active.
What is KAITLYN BOUDREAU (LCSW)'s primary classification?
Social Worker is the headline specialty for KAITLYN BOUDREAU (LCSW) here. Clinical services aligned with this taxonomy classification.
Where is KAITLYN BOUDREAU (LCSW) based?
KAITLYN BOUDREAU (LCSW) is tied to Waterville, Maine in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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