Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Matthew Ian Bouchard, LICSW

Individual provider Clinical Social Worker · NPI 1174106884

Matthew Ian Bouchard, LICSW is a Clinical Social Worker in Burlington, Vermont. Licensed in Vermont. Registered with an NPI since 2021.

Licensed in
VT
In the registry since
2021
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

128 Lakeside Ave Ste 260
Burlington, VT 05401-5911
Phone: (802) 657-7087
Fax: (802) 657-7078
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 089.0134397 (VT)

Record details

NPI number1174106884
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedApril 30, 2021
Last updated in NPPESApril 30, 2021
Certification dateJanuary 14, 2021
Mailing address128 Lakeside Ave Ste 260, Burlington, VT 05401-5911

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