Individual
JOHNDA ANN BOUTHILLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LADC
Contact information
Practice address
47 TOWN ST, NORWICH, CT 06360-2315
(860) 892-7042
(860) 892-7043
Mailing address
47 TOWN ST, NORWICH, CT 06360-2315
(860) 892-7042
(860) 892-7043
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000505
CT
1041C0700X
Clinical Social Worker
003961
CT
Other
Enumeration date
06/04/2006
Last updated
09/11/2025
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