Individual provider Active NPI

Clifton Boudreaux Jr.

  • Pastoral Counselor
  • Baton Rouge, LA
National Provider Identifier
1194629592
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
License
18655 Issued in TX
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, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.