MR. JEREMY PAUL BOUDREAUX (NPI# 1790247757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790247757 |
| Entity Type | Individual |
| Full Name | MR. JEREMY PAUL BOUDREAUX |
| Credential | LCSW |
| Practice Address |
927 Broadway St Ste 331 Quincy IL 62301-2721 |
| Mailing Address |
Po Box 7005 Quincy IL 62305-7005 |
| Practice Telephone | 2172238400 |
| Mailing Telephone | 2172231200 |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2019-04-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149020671 | IL | Behavioral Health & Social Service Providers |
| Street Address |
927 BROADWAY ST STE 331 |
| City | QUINCY |
| State | IL |
| Zip Code | 62301-2721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508951781 | Lanny E Stiles | Psychiatry & Neurology | 927 Broadway St Ste 331, Quincy, IL 62301-2721 | 2006-10-04 |
| 1710593124 | Andrea Nikole Leezer | Social Worker | 927 Broadway St Ste 331, Quincy, IL 62301-2721 | 2020-09-21 |
| 1528607959 | Candice Lynn Murrell-cannon | Counselor | 927 Broadway St Ste 331, Quincy, IL 62301-2721 | 2020-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969471 | Lutheran Child and Family Service of Illinois | Foster Care Agency | 1400 N. 30th St, Quincy, IL 62301 | 2020-07-07 |
| 1134749716 | Bethany Nicole Jumps | Pharmacist | Broadway St & N 11th St, Quincy, IL 62301 | 2020-04-23 |
| 1043844293 | S.crider Construction An Supply Corp. | Contractor | 529 Woodbridge Dr., Quincy, IL 62301 | 2020-02-26 |
| 1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
| 1043851488 | West Central Illinois Nutrition | In Home Supportive Care | 639 York St. Room 333, Quincy, IL 62301 | 2019-10-07 |
| 1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
| 1194255083 | Michael Andrew Behrens | Nurse Practitioner | Broadway and 11th Street, Quincy, IL 62301 | 2017-06-14 |
| 1770987323 | Kirsty Yvonne Reed | Counselor | 205 S. 24th Street, Chaddock, Quincy, IL 62301 | 2014-10-10 |
| 1114234499 | Dale D. Shahan Dds Ltd | Dentist | 636 Hampshire Suite 102, Quincy, IL 62301 | 2010-09-08 |
| 1730314071 | James D Kaufmann | Pharmacist | 14th & Broadway, Quincy, IL 62301 | 2009-05-15 |
| Find all providers in zip 62301 | ||||
| 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 |
|---|---|---|---|---|
| 1831726165 | Saira Lopes | Social Worker | 17 Greenleaf St Apt 5, Quincy, MA 02169-4443 | 2020-03-25 |
| 1649804931 | Nancy Clarke | Social Worker | 179 Thomas Burgin Pkwy, Quincy, MA 02169-4222 | 2020-02-26 |
| 1922564368 | Arealus Pough | Social Worker | 1 Dunns Hill Rd Apt 4, Quincy, MA 02169-4157 | 2019-02-11 |
| 1730658824 | David S Novak | Social Worker | 81 Albatross Rd, Quincy, MA 02169-2601 | 2018-11-19 |
| 1164991725 | Carrie Little | Social Worker | 207 County Hospital Road Suite 109, Quincy, CA 95971 | 2018-11-13 |
| 1023592748 | Rachel Sonia John | Social Worker | 625 Thomas Burgin Pkwy Apt 419, Quincy, MA 02169-7654 | 2018-09-18 |
| 1013499300 | Elizabeth Robinson | Social Worker | 44 Shea St, Quincy, MA 02169-5840 | 2018-09-03 |
| 1730661190 | Yvonne Ann Roth | Social Worker | 1 Enterprise Drive, Quincy, MA 02171 | 2018-09-03 |
| 1932687985 | Stacey Barker | Social Worker | 11 Copley St, Quincy, MA 02170-3033 | 2018-08-01 |
| 1932686250 | Lee-anne Jacobs | Social Worker | 100 Hancock St Fl 7, Quincy, MA 02171-1745 | 2018-07-20 |
| Find all providers in QUINCY | ||||
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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.