NPIMap

Organization Active NPI

Coventures LLC

  • Clinical Social Worker
  • Monroe, MI
National Provider Identifier
1457568784
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801035097 Issued in MI
Legal business name
COVENTURES LLC
Practice address
986 S Telegraph Rd
Monroe, MI 48161-4097
Phone
(734) 770-7573
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Michael Boudrie, LMSW, LPC
Title
Co-Owner
Phone
74347707573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801035097 MI Primary

Addresses

Primary practice location

986 S Telegraph Rd
Monroe, MI 48161-4097

Mailing address

4328 Cousino
La Salle, MI 48145-9623

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1457568784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 COUSINO",
            "city": "LA SALLE",
            "state": "MI",
            "postal_code": "481459623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "986 S TELEGRAPH RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481614097",
            "telephone_number": "734-770-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "BOUDRIE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "74347707573",
        "authorized_official_credential": "LMSW, LPC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801035097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.