Active NPI
Johnpaul C Boulden, M.ED., LPC
- Counselor
- Port Royal, SC
National Provider Identifier
1053049205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 7121
- Practice address
- 1006 Paris Ave
Port Royal, SC 29935-2442 - Phone
- (843) 277-6779
- NPI assigned
- Aug 15, 2022
- Last updated
- Apr 23, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 7121 | SC | MD | Counselor |
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
- Beaufort-Jasper-Hampton Comprehensive Health Service,Inc
- Mark Allen Bechtel, D.O.
- Bio-Medical Applications of South Carolina, Inc. (FMC Dialysis Services Low Country Dialysis)
- Yasmine Chate Bivins, PHARMD
- Blueprint for Change
- Alfredo Jorge Brand, MD
- Rose Mindel Brown, RDH
- Brian Joseph Burger, APRN
- Jared Michael Campbell, MSW
- Ugochi Cantave, MD
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.