Healthcare Provider Details

I. General information

NPI: 1407005341
Provider Name (Legal Business Name): KIMBERLY L ABRAM LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIM L BOUTIN

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 LEBANON RD
BOZRAH CT
06334-1116
US

IV. Provider business mailing address

44 MACLYN DR
COLCHESTER CT
06415-2041
US

V. Phone/Fax

Practice location:
  • Phone: 860-788-5462
  • Fax:
Mailing address:
  • Phone: 860-966-1292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: