DR. CHARLES ANTHONY BOUDREAUX JR. (NPI# 1174647432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174647432 |
| Entity Type | Individual |
| Full Name | DR. CHARLES ANTHONY BOUDREAUX JR. |
| Practice Address |
431 N State St Jackson MS 39201-1108 |
| Mailing Address |
301 Remington Dr Brandon MS 39042-2865 |
| Practice Telephone | 6019491949 |
| Practice Fax Number | 6017146922 |
| Mailing Telephone | 6019491949 |
| Mailing Fax Number | 6017146922 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YP2500X |
Counselor Specialization: Professional |
0980 | MS | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | T0023 | MS | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427138502 | Charles Austin Boudreaux | Dentist | 5589 Canal Blvd, New Orleans, LA 70124-2745 | 2006-10-16 |
| 1962495325 | Charles Anthony Boudreaux | Anesthesiology | 3315 Watt Ave, Sacramento, CA 95821-3600 | 2005-08-31 |
| Street Address |
431 N STATE ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39201-1108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871617423 | Karen White Jones | Counselor | 431 N State St, Jackson, MS 39201-1108 | 2007-03-19 |
| 1912520768 | James Charles Haycraft | Marriage & Family Therapist | 431 N State St, Jackson, MS 39201-1108 | 2020-05-27 |
| 1548758832 | Lisa Allegrezza Sorey | Counselor | 431 N State St, Jackson, MS 39201-1108 | 2018-04-23 |
| 1609287531 | William Mcneese Jr. | Counselor | 431 N State St, Jackson, MS 39201-1108 | 2014-05-13 |
| 1902217805 | Laurel Boyd | Counselor | 431 N State St, Summit Counseling, Jackson, MS 39201-1108 | 2014-05-13 |
| 1134424450 | Ronald Gene Mumbower | Psychologist | 431 N State St, Jackson, MS 39201-1108 | 2011-01-18 |
| 1427350453 | Donald E. Waller | Counselor | 431 N State St, Jackson, MS 39201-1108 | 2010-11-23 |
| 1285935932 | Summit Counseling | Counselor | 431 N State St, Jackson, MS 39201-1108 | 2010-11-11 |
| 1184938060 | Lee Smith | Counselor | 431 N State St, Jackson, MS 39201-1108 | 2010-08-03 |
| 1942464904 | Fred G. Davis Sr. | Marriage & Family Therapist | 431 N State St, Jackson, MS 39201-1108 | 2008-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962836874 | Tanericha Lashay Anderson | In Home Supportive Care | 3200 Jackson St, Jackson, MS 39201 | 2013-08-27 |
| 1912383779 | Mississippi Health Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 W Amite St, Jackson, MS 39201-1203 | 2015-08-04 |
| 1336647221 | Mississippi Care, LLC | Community/Behavioral Health | 100 W Amite St, Jackson, MS 39201-1203 | 2018-01-25 |
| 1861894420 | Iesha Bridges Smith | Occupational Therapist | 170 E Griffith St Apt 209, Jackson, MS 39201-1396 | 2014-09-25 |
| 1336374495 | Cynthia Nicole Lawson | Counselor | 200 N Congress St Ste 100, Jackson, MS 39201-1902 | 2009-05-19 |
| 1275688137 | Kelly L Wilson | Social Worker | 200 N Congress St, Suite 100, Jackson, MS 39201-1902 | 2007-01-23 |
| 1780132787 | Zakia Simpson | Social Worker | 200 N Congress St Ste 100, Jackson, MS 39201-1902 | 2016-09-19 |
| 1487101499 | Sandra Jeanette Lee | Social Worker | 200 N Congress St, Jackson, MS 39201-1902 | 2016-09-07 |
| 1730586173 | Miracle Paige | Counselor | 200 N Congress St, Jackson, MS 39201-1902 | 2014-12-01 |
| 1316293095 | Kelli Leo | Counselor | 200 N Congress St, Suite 100, Jackson, MS 39201-1902 | 2012-07-31 |
| Find all providers in zip 39201 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902411663 | Kristen Camille Kapler | Counselor | 3899 Division Rd, Jackson, WI 53037-9707 | 2020-09-10 |
| 1992339071 | Open Door Family Counseling | Counselor | 316 S Brown St Ste A, Jackson, MI 49203-1481 | 2020-02-27 |
| 1891334108 | Jamie Alane Merrill | Counselor | 1214 Greenwood Ave, Jackson, MI 49203-3037 | 2020-01-03 |
| 1285273078 | Hall Consulting Services LLC | Counselor | 1155 Briarwood Dr, Jackson, MS 39211-4204 | 2019-12-27 |
| 1114496387 | New Direction Counseling Center, LLC | Counselor | 1200 N West Ave Ste 809, Jackson, MI 49202-2196 | 2018-11-17 |
| 1811490964 | Lifeworks Resources, LLC | Counselor | 575 S Royal St Ste 24, Jackson, TN 38301-7307 | 2018-03-15 |
| 1912409764 | Impact Behavioral Counseling LLC | Counselor | 1551 E County Line Rd Ste B, Jackson, MS 39211-1801 | 2018-03-07 |
| 1831697317 | Denise June Johnson | Counselor | 906 Lincoln St, Jackson, MI 49202-3251 | 2018-01-30 |
| 1033626031 | Heather R. Chruch | Counselor | 180 W Michigan Ave Ste 204, Jackson, MI 49201-1342 | 2017-12-29 |
| 1861908337 | Matthew T Tompkins | Counselor | 810 E Jackson Blvd Ste B1, Jackson, MO 63755-2400 | 2017-12-20 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on DR. CHARLES ANTHONY BOUDREAUX JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.