KRISTEN BEAUDOUIN (LICSW) – Clinical Social Worker, NPI 1073923918

KRISTEN BEAUDOUIN (LICSW) is a healthcare provider. based in Jamaica plain, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 085024 (NY). The NPI Number for KRISTEN BEAUDOUIN (LICSW) is 1073923918

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
KRISTEN BEAUDOUIN (LICSW)
NPI
1073923918
Phone
(617) 390-1259
Address
157 GREEN ST
Enumeration Date
30 April 2014
Last Update Date
2 October 2018

Doctor Profile

Medical School Name
COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Secondary Phone
6175224400
Graduation Year
2011 (15 years ago)
PAC ID
6406260637
Group Practice PAC ID
6800975574
Professional Enrollment ID
I20210130000100
Address ID
MA021302156BO49XXXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:12State licenses:2Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

Provider Addresses for KRISTEN BEAUDOUIN (LICSW)

  • 157 GREEN ST

    JAMAICA PLAIN, MA 021302667

    Phone: (617) 390-1259

    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: 2021-01-30

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
I20210130000100IClinical Social WorkerMATBD

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 02130)

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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: 6800975574View full group profile
NameSpecialtyState
-MA
Nurse PractitionerMA
P S Y C H I A T R YMA
P S Y C H I A T R YMA
Psychiatry, Addiction MedicineMA
Clinical Social WorkerMA
P S Y C H I A T R YMA
P S Y C H I A T R YMA
P S Y C H I A T R YMA
Clinical Social WorkerMA

Reviews

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Frequently asked questions

Can I use this page to confirm KRISTEN BEAUDOUIN (LICSW)'s NPI?
Yes. KRISTEN BEAUDOUIN (LICSW) is listed with NPI 1073923918 in the public NPI dataset.
Does CMS list KRISTEN BEAUDOUIN (LICSW) as active?
Yes — KRISTEN BEAUDOUIN (LICSW) is active in the NPI listing used on this page.
What healthcare role does KRISTEN BEAUDOUIN (LICSW) hold?
Scheduling teams often label KRISTEN BEAUDOUIN (LICSW) under Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does KRISTEN BEAUDOUIN (LICSW) list a practice location?
Patients near Jamaica Plain, Massachusetts may find KRISTEN BEAUDOUIN (LICSW) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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