Charles Anthony Boudreaux Jr.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0980 Issued in MS

Practice address

431 N State St
Jackson, MS 39201-1108

Phone

(601) 949-1949

Fax

(601) 714-6922

NPI assigned

Mar 19, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Summit Counseling

  • Marriage & Family Therapist
  • Jackson, MS
  • NPI 1285935932

  Professional

  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1174647432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 REMINGTON DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422865",
            "telephone_number": "601-949-1949",
            "fax_number": "601-714-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392011108",
            "telephone_number": "601-949-1949",
            "fax_number": "601-714-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "0980",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MS",
            "license": "T0023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter John Boswell, DMD
• Zachary Gage Boswell, DO
• Haley Carpenter Boteler, OTD, OTR/L
• William L. Boteler, D.D.S., P.A.
• Avery Bouchillon
• Jean A Boudreaux, PHD
• Marshall J Bouldin IV, M.D.
• Sheila Bouldin, M.D.
• Sherry Bouldin, LPC
• Nicholas Boullard, MD

• Professional Counselor in Jackson, MS
• Providers in Jackson, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.