Individual provider Active NPI

Johnpaul C Boulden, M.ED., LPC

  • Counselor
  • Port Royal, SC
National Provider Identifier
1053049205
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
7121 Issued in SC
Practice address
1006 Paris Ave
Port Royal, SC 29935-2442
Phone
(843) 277-6779
NPI assigned
Aug 15, 2022
Last updated
Apr 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 7121 SC Primary

Addresses

Primary practice location

1006 Paris Ave
Port Royal, SC 29935-2442

Mailing address

1006 Paris Ave
Port Royal, SC 29935-2418
Phone (843) 277-6779

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.pcaportroyal.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
7121SCMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1053049205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 PARIS AVE",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299352418",
            "telephone_number": "843-277-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 PARIS AVE",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299352442",
            "telephone_number": "843-277-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULDEN",
        "first_name": "JOHNPAUL",
        "middle_name": "C",
        "credential": "M.ED., LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-15",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "7121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.pcaportroyal.com",
            "affiliation": "N",
            "endpointDescription": "web address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1006 Paris Ave",
            "city": "Port Royal",
            "state": "SC",
            "country_code": "US",
            "postal_code": "299352418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port Royal, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.