MR. JERRY PAUL BOUDREAUX L C S W
NPI 1366515702
Social Worker - Clinical in Gulfport, MS

Active since November 15, 2006
549 E PASS RD, SUITE P, GULFPORT, MS 39507(228) 896-9251(228) 897-6003 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Jerry Paul Boudreaux L C S W NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JERRY PAUL BOUDREAUX L C S W (NPI 1366515702) is an individual clinical provider in Gulfport, Mississippi, licensed in Mississippi (0058) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1366515702
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. JERRY PAUL BOUDREAUXCredential: L C S W
Location Address549 E PASS RD, SUITE PGulfport, MS 39507-3261
Mailing Address549 E Pass Rd, Suite PGulfport, MS 39507-3261 · (228) 896-9251 · Fax (228) 897-6003
Fax(228) 897-6003
Sole ProprietorNo
Enumeration DateNovember 15, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1366515702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MS · 0058
Definition
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.
549 E PASS RD, Gulfport, MS 39507

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Psychiatric/Mental Health)
549 E PASS RD
GULFPORT, MS 39507
Nurse Practitioner (Psychiatric/Mental Health)
549 E PASS RD
GULFPORT, MS 39507

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Boudreaux's NPI number?

The NPI number for Jerry Boudreaux is 1366515702. It was assigned to this individual provider in the NPPES registry on November 15, 2006.

Where is Jerry Boudreaux located?

Jerry Boudreaux practices at 549 E Pass Rd Suite P, Gulfport, MS 39507. The listed phone number is (228) 896-9251.

What is Jerry Boudreaux's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Jerry Boudreaux was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.