Individual provider Active NPI

Brenda A Boudreaux, MSW LMSW

  • Social Worker
  • Wayne, MI
National Provider Identifier
1285698159
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801079489 Issued in MI
Practice address
33101 Annapolis St
Suite B
Wayne, MI 48184-2405
Phone
(734) 721-0200
Fax
(734) 721-1766
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801079489 MI Primary

Addresses

Primary practice location

33101 Annapolis St
Suite B
Wayne, MI 48184-2405

Mailing address

9102 Cheyenne
Detroit, MI 48228
Phone (313) 416-3133

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Intervention Network Inc. Past Accepting new patients
Hegira Health, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285698159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9102 CHEYENNE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48228",
            "telephone_number": "313-416-3133",
            "fax_number": "313-416-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33101 ANNAPOLIS ST",
            "address_2": "SUITE B",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842405",
            "telephone_number": "734-721-0200",
            "fax_number": "734-721-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "BRENDA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MSW LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801079489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.