MR. KENNY JOSEPH BOUDREAUX BA. B.S. PSYCHOLOGY
NPI 1750606646
Case Manager/Care Coordinator in Gautier, MS

Q: What is Kenny Boudreaux's NPI number?

The NPI number for Kenny Boudreaux is 1750606646. It was assigned to this individual provider in the NPPES registry on April 2, 2010.

Q: What is Kenny Boudreaux's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

Q: When was this NPI record last updated?

The NPPES record for Kenny Boudreaux was last updated on April 2, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since April 02, 2010

3407 SHAMROCK CT, GAUTIER, MS 39553(228) 497-0690(228) 497-1363 Get Directions Write a Review

NPPES record last updated: April 2, 2010. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Mr. Kenny Joseph Boudreaux Ba. B.s. Psychology NPPES

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

MR. KENNY JOSEPH BOUDREAUX BA. B.S. PSYCHOLOGY (NPI 1750606646) is an individual case manager/care coordinator provider in Gautier, Mississippi and active in the NPI registry since April 2010.

NPPES Registry Identity

NPI1750606646

Entity TypeIndividualMale

Primary Taxonomy171M00000X

Provider Legal NameMR. KENNY JOSEPH BOUDREAUXCredential: BA. B.S. PSYCHOLOGY

Location Address3407 SHAMROCK CTGautier, MS 39553-6429

Mailing Address3407 Shamrock CtGautier, MS 39553-6429 · (228) 497-0690 · Fax (228) 497-1363

Phone(228) 497-0690

Fax(228) 497-1363

Sole ProprietorNo

Enumeration DateApril 2, 2010

✔ NPI 1750606646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers

Taxonomy Code171M00000X

Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

3407 SHAMROCK CT, Gautier, MS 39553

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Other Identifiers 1

Medicaid00018214MS

Other Providers at the Same Location NPPES 20

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

MS. PEGGY LYNN FENDLEY M.ED.

Counselor (Mental Health)