JUNE BOUDREAUX (NPI# 1013526177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013526177 |
| Entity Type | Individual |
| Full Name | JUNE BOUDREAUX |
| Credential | CPSS |
| Practice Address |
1600 Broad Ave Gulfport MS 39501-3603 |
| Mailing Address |
Po Box 6705 Gulfport MS 39506-6705 |
| Practice Telephone | 2288631132 |
| Practice Fax Number | 2288651700 |
| Mailing Telephone | 2288651330 |
| Mailing Fax Number | 2288651331 |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 70 | MS | Other Service Providers |
| Street Address |
1600 BROAD AVE |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-3603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417934175 | Gulf Coast Mental Health Center | Psychologist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2005-12-23 |
| 1043811839 | Kathy Ulland | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-11-06 |
| 1508463357 | Nicole Brown | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-10-05 |
| 1407453376 | Brian Weber | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-10-05 |
| 1457958639 | Krysten Vagedes | Registered Nurse | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-10-01 |
| 1184239436 | Yeinil Guzman | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-09-14 |
| 1972117216 | Nicole Hymel | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-09-03 |
| 1053921668 | Dana Alexis Mixon | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-08-07 |
| 1801405964 | Elizabeth Moran | Peer Specialist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-07-24 |
| 1407464738 | Laura Elizabeth Johnson | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801405964 | Elizabeth Moran | Peer Specialist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-07-24 |
| 1316555329 | Madeline Nicklas | Peer Specialist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-07-15 |
| 1023660693 | Jesse Gruich | Peer Specialist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2019-07-12 |
| 1073077418 | Robert Revell | Peer Specialist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2019-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497387641 | Redimere Recovery Resources LLC | Peer Specialist | 4646 Meadow Lake Dr, Tupelo, MS 38801-7928 | 2020-02-05 |
| 1770944977 | Judy Dillard | Peer Specialist | 2100 Chambers Drive, Booneville, MS 38829 | 2016-03-15 |
| 1760082580 | Kimberly Eve Spence | Peer Specialist | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-10-30 |
| 1508470121 | Hannah Olivia Booker | Peer Specialist | 4905 Telephone Rd, Pascagoula, MS 39567-1823 | 2020-09-01 |
| 1134733967 | Elizabeth Ann Shepard-bynum | Peer Specialist | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2020-08-31 |
| 1962031468 | Frank Pace | Peer Specialist | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-04-06 |
| 1982230058 | Hannah Jade Mixon | Peer Specialist | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-03-20 |
| 1902430887 | Telena T Harmon | Peer Specialist | 3452 Pascagoula St Ste 3, Pascagoula, MS 39567-3203 | 2020-02-28 |
| 1700417110 | Jennifer Nicole Zaha | Peer Specialist | 152 Highway 7 S, Oxford, MS 38655-5392 | 2020-02-04 |
| 1942847652 | Suzanne Shepherd | Peer Specialist | 152 Highway 7 S, Oxford, MS 38655-5392 | 2019-12-02 |
| Find all providers with the same taxonomy | ||||
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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.