Tracy L Boudrie, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401017135 Issued in MI

Practice address

11521 Joseph Campau St
Hamtramck, MI 48212-3050

Phone

(313) 733-4256

Fax

(313) 733-4265

NPI assigned

Mar 17, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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

• National Associations of Yemeni Americans, Inc

  • Professional Counselor
  • Dearborn, MI
  • NPI 1689338949

  Counselor

  NPD

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1205252129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11521 JOSEPH CAMPAU ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123050",
            "telephone_number": "313-500-7884",
            "fax_number": "313-766-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11521 JOSEPH CAMPAU ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123050",
            "telephone_number": "313-733-4256",
            "fax_number": "313-733-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDRIE",
        "first_name": "TRACY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401017135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "6401017135",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LLPC",
            "identifier": "6401015444",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED SOCIAL SERVICE TECHNICIAN",
            "identifier": "6803086484",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Big Smile Consulting, LLC
• Big Smile Mobile Hygiene Clinic
• Sami Suheil Bilani, D.D.S.
• Bio-Medical Applications of Michigan, Inc.
• Kaitlin Bloodworth, C/LMT
• Bridge Home Care LLC
• Sierra Brinson-Kelley, CH-C
• Dzevada Bukaric
• Sophia Caccamo
• Cambridge Psychiatry & Behavioral Institute PLLC

• All providers in Hamtramck, MI
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.