Active NPI
Clifton Boudreaux Jr.
- Pastoral Counselor
- Baton Rouge, LA
National Provider Identifier
1194629592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 18655
- Practice address
- 11616 Southfork Ave Ste 403
Baton Rouge, LA 70816-5241 - Phone
- (225) 261-7143
- NPI assigned
- Oct 7, 2026
- Last updated
- Oct 7, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 18655 | TX | Primary |
Addresses
Primary practice location
11616 Southfork Ave Ste 403
Baton Rouge, LA 70816-5241
Mailing address
1206 Green Knoll Dr
Sugar Land, TX 77479-6005
Phone (832) 628-1074
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791331200000",
"number": "1194629592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1206 GREEN KNOLL DR",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774796005",
"telephone_number": "832-628-1074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11616 SOUTHFORK AVE STE 403",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708165241",
"telephone_number": "225-261-7143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUDREAUX",
"first_name": "CLIFTON",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-10-07",
"last_updated": "2026-10-07",
"certification_date": "2026-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "TX",
"license": "18655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.