Kristen Leigh Boudreau, P.C.C.
Individual provider Active NPI Professional Counselor · Powell, OH
NPI 1629211388 · NPPES record last updated Oct 15, 2011
Key facts
- NPI
- 1629211388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- C.0701103 (OH)
- Practice address
- 10330 Sawmill Pkwy
Suite 300
Powell, OH 43065-7790 - Phone
- (614) 477-4390
- NPI assigned
- Apr 10, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.0701103 | OH | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C.0701103 | OH | Yes |
Addresses
Primary practice location
10330 Sawmill Pkwy
Suite 300
Powell, OH 43065-7790
Mailing address
PO Box 3342
Dublin, OH 43016-0161
Phone (614) 477-4390
Other providers in Powell, OH
- James Edward Blank
- Timothy Paul Blecke
- Mindy Jo Blevins
- Reza Bolourian
- Boudreau Counseling Services
- Michael Todd Bozzo
- Lillian Hannah Breese
- Brenda J. Stone LLC
- Bright Communicators, LLC
- Bright Reflections Dental Studio
All providers in Powell, OH · Professional Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.