Ellen Boudreaux, CPSS, ITE

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

711 Colonial Dr Ste D
Baton Rouge, LA 70806-6549

Phone

(225) 246-2162

NPI assigned

Jun 1, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ellen Chew Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1003308396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 RIDGEPOINT CT",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102877",
            "telephone_number": "225-636-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 COLONIAL DR STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066549",
            "telephone_number": "225-246-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "ELLEN",
        "credential": "CPSS, ITE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "CHEW",
            "credential": "CPSS, ITE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brynlee Boudreaux
• Chanice Unchelle Boudreaux, LMT
• Daniel Christopher Boudreaux, PA-C
• Danielle Boudreaux, BCBA, LBA
• David A Boudreaux
• Emily Olinde Boudreaux, PH.D.
• Jason Grady Boudreaux, MD
• Jessica Nicole Boudreaux
• Kelly James Boudreaux Jr., M.D.
• Kristen Pilcher Boudreaux, CRNA

• Peer Specialist in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Peer Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.