SHADI MAY BOUDREAU (NPI# 1407361090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407361090 |
| Entity Type | Individual |
| Full Name | SHADI MAY BOUDREAU |
| Credential | LPC |
| Practice Address |
810 N 6th Ave Phoenix AZ 85003-1318 |
| Mailing Address |
4201 N 20th St Unit 225 Phoenix AZ 85016-5486 |
| Practice Telephone | 6026252529 |
| Mailing Telephone | 6026252529 |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2017-12-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
16954 | AZ | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
16954 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
810 N 6TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85003-1318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598767790 | Andrea Shunette Waddell-pratt | Psychologist | 810 N 6th Ave, Phoenix, AZ 85003-1318 | 2005-06-01 |
| 1013470251 | Kimberly Turille | Counselor | 810 N 6th Ave, Phoenix, AZ 85003-1318 | 2019-04-12 |
| 1669930855 | Andrew Maurer | Marriage & Family Therapist | 810 N 6th Ave, Phoenix, AZ 85003-1318 | 2019-03-06 |
| 1942714613 | The Phoenix Counseling Collective | Counselor | 810 N 6th Ave, Phoenix, AZ 85003-1318 | 2017-11-16 |
| 1407398100 | Gina Michelle Lang | Psychologist | 810 N 6th Ave, Phoenix, AZ 85003-1318 | 2016-11-11 |
| 1194102582 | Spane Counseling | Counselor | 810 N 6th Ave, Phoenix, AZ 85003-1318 | 2015-05-05 |
| 1558796482 | Life Choices Professional Group, LLC | Community/Behavioral Health | 810 N 6th Ave, Phoenix, AZ 85003-1318 | 2013-09-11 |
| 1811228752 | Shalene Michele Kirkley | Psychologist | 810 N 6th Ave, Phoenix, AZ 85003-1318 | 2010-01-15 |
| 1083853147 | Wooten & Associates, Plc | Psychologist | 810 N 6th Ave, Phoenix, AZ 85003-1318 | 2009-02-13 |
| 1629277124 | Andrea Waddell-pratt, Phd, PC | Community/Behavioral Health | 810 N 6th Ave, Phoenix, AZ 85003-1318 | 2007-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518504406 | Jennifer A Day | Counselor | 125 South Avenue, Phoenix, AZ 85003 | 2019-12-10 |
| 1588148993 | Jillian Ralston | Optometrist | 112 W Mcdowell Road, Phoenix, AZ 85003 | 2018-09-20 |
| 1699254839 | Corner Pharmacy Incorporated | Pharmacy | 112 N 5th Ave Ste 101, Phoenix, AZ 85003 | 2018-08-08 |
| 1003279043 | Kimberly Brown | Technician, Other | 609 N 2nd Aveunue, 200, Phoenix, AZ 85003 | 2016-03-29 |
| 1548678626 | Douglas Barshter | Technician, Other | 602 N 2nd Avenue, Phoenix, AZ 85003 | 2014-08-01 |
| 1346655099 | Benjamin Heller | Family Medicine | 515 W Buckeye Rd Ste 104, Phoenix, AZ 85003 | 2014-06-20 |
| 1225383201 | Charles S Bell | Counselor | 609 North 2nd Ave., Phoenix, AZ 85003 | 2012-07-17 |
| 1790004133 | Arizona Cvs Stores, L.L.C. | Durable Medical Equipment & Medical Supplies | 50 W. Jefferson St., Suite 140, Phoenix, AZ 85003 | 2010-05-25 |
| 1184806960 | Word Play, LLC | Home Health | 808 N 4th Ave Unit 12, Phoenix, AZ 85003 | 2007-12-03 |
| 1609067842 | Salim Shafi | Dentist | 125 W Mcdowell Road, Phoenix, AZ 85003 | 2007-08-05 |
| Find all providers in zip 85003 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557729 | Psychological and Consulting Services LLC | Counselor | 331 N 1st Ave Ste 102, Phoenix, AZ 85003-4528 | 2020-10-27 |
| 1447863683 | Mindscape Wellness LLC | Counselor | 4545 N 36th St Ste 117, Phoenix, AZ 85018-3473 | 2020-08-27 |
| 1700496718 | Suma Hodge | Counselor | 2341 N 83rd Dr, Phoenix, AZ 85037-3742 | 2020-08-04 |
| 1992322127 | North Pointe Services | Counselor | 1807 W Sienna Bouquet Pl, Phoenix, AZ 85085-8042 | 2020-07-03 |
| 1023630308 | Mary Squires Moran | Counselor | 14040 N Cave Creek Rd Ste 205, Phoenix, AZ 85022-6179 | 2020-05-10 |
| 1467087106 | Omnipotent Health Services | Counselor | 3442 W Paradise Dr, Phoenix, AZ 85029-2239 | 2020-03-03 |
| 1124650536 | Erica Van Parys | Counselor | 3207 E Medlock Dr, Phoenix, AZ 85018-1426 | 2020-02-05 |
| 1790324556 | Amy Kathleen Engle | Counselor | 2432 W Peoria Ave Ste 1123, Phoenix, AZ 85029-4733 | 2019-12-26 |
| 1851934012 | Extinguishing Fear Life Coaching | Counselor | 4435 E Chandler Blvd, Phoenix, AZ 85048-7649 | 2019-10-21 |
| 1134761661 | Kerry Jean Ramella | Counselor | 809 W Maryland Ave, Phoenix, AZ 85013-1325 | 2019-10-16 |
| Find all providers in PHOENIX | ||||
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| 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.