MR. JERRY PAUL BOUDREAUX (NPI# 1366515702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366515702 |
| Entity Type | Individual |
| Full Name | MR. JERRY PAUL BOUDREAUX |
| Credential | L C S W |
| Practice Address |
549 E Pass Rd Suite P Gulfport MS 39507-3261 |
| Practice Telephone | 2288969251 |
| Practice Fax Number | 2288976003 |
| Mailing Telephone | 2288969251 |
| Mailing Fax Number | 2288976003 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
0058 | MS | Behavioral Health & Social Service Providers |
| Street Address |
549 E PASS RD SUITE P |
| City | GULFPORT |
| State | MS |
| Zip Code | 39507-3261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609389105 | Karen R Burns | Speech-Language Pathologist | 3506 Washington Avenue, Ste E, Gulfport, MS 39507 | 2017-11-07 |
| 1538605027 | Andrea Broussard | Personal Emergency Response Attendant | 406 Pass Rd, Gulfport, MS 39507 | 2017-01-09 |
| 1366872491 | William Alexis Marcia | Pharmacist | 1444 East Pass Road, Gulfport, MS 39507 | 2013-11-27 |
| 1740599380 | Advanced Hearing Systems, Inc. | Hearing Instrument Specialist | 401 Security Square, Gulfport, MS 39507 | 2010-09-30 |
| 1497068118 | Stacey Ritter Carter | Dentist | 1635 East Pass Road, Gulfport, MS 39507 | 2010-07-22 |
| 1477789964 | Letonoff Orthopaedics & Sports | Orthopaedic Surgery | 452 Court House Road, Suite G, Gulfport, MS 39507 | 2009-06-10 |
| 1730385139 | Bernard Frederick Podlin | Dentist | 400 Pass Road, Gulfport, MS 39507 | 2007-06-22 |
| 1043422553 | Mark D Stringer | Dentist | 520-a Courthouse Road, Gulfport, MS 39507 | 2007-05-04 |
| 1154543528 | Pass Road Elementary | Registered Nurse | 37 Pass Road, Gulfport, MS 39507 | 2007-05-03 |
| 1417073768 | John Hough Hopkins | Dentist | 3303 A Ave, Gulfport, MS 39507 | 2007-03-21 |
| Find all providers in zip 39507 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871120832 | Deena Asfour-mack | Social Worker | 12450 Three Rivers Rd Apt 57, Gulfport, MS 39503-2974 | 2020-03-26 |
| 1871076935 | Janice Luiszer Lemieux | Social Worker | 5005 24th Ave S, Gulfport, FL 33707-5111 | 2018-09-13 |
| 1588157374 | Elizabeth Boehm Zimmerman | Social Worker | 1613 23rd Ave, Gulfport, MS 39501-2960 | 2018-06-07 |
| 1003324419 | Tbd Acquisition II, LLC | Social Worker | 11150 Highway 49 Ste B, Gulfport, MS 39503-4110 | 2018-01-19 |
| 1194239392 | Jennifer Lynn Williams | Social Worker | 5301 Snead St, Gulfport, MS 39501-9018 | 2017-11-27 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| 1821528183 | Isaure Caviness | Social Worker | 1323 Poplar Ave, Gulfport, MS 39507-2044 | 2017-06-19 |
| 1487907168 | Elizabeth Willis Waterman | Social Worker | 12236 Ashley Dr, Suite B, Gulfport, MS 39503-2759 | 2012-10-18 |
| 1538491634 | Heather Wittmann Black | Social Worker | 2214 25th Ave Unit 2, Gulfport, MS 39501-4520 | 2010-02-01 |
| 1659503712 | Lynn T. Murphy | Social Worker | 13613 Hidden Oaks Dr, Gulfport, MS 39503-7049 | 2009-08-21 |
| Find all providers in GULFPORT | ||||
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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.