Malinda Charisse Boudreaux, LPC
Individual provider Active NPI Mental Health Counselor · Orange, TX
NPI 1639280415 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1639280415
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 16733 (TX)
- Practice address
- 8885 Taylor Cir
Orange, TX 77630-8822 - Phone
- (409) 720-7292
- Fax
- (409) 735-3632
- NPI assigned
- Aug 31, 2006
- 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 |
|---|---|---|---|
| 16733 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 16733 | TX | Yes |
Addresses
Primary practice location
8885 Taylor Cir
Orange, TX 77630-8822
Mailing address
8885 Taylor Cir
Orange, TX 77630-8822
Phone (409) 720-7292
Other providers in Orange, TX
- Bio-Medical Applications of Texas, Inc.
- Biotronics Kidney Center of Beaumont, Inc
- Josh Bland
- Nicole Block
- Allisha Gayle Skinner Bonneaux
- Reatha Jeannette Bradberry I
- Tara Breaux
- Brewer Dental PLLC
- Bright Branch ABA, LLC
- Bright Futures Pediatric Therapy
All providers in Orange, TX · Mental Health Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.