Active NPI
Nicole Boudreaux, LCSWA
- Clinical Social Worker
- Cherokee, NC
National Provider Identifier
1669006730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P013735
- Practice address
- 1 Hospital Rd
Caller Box C-268
Cherokee, NC 28719-2871 - Phone
- (828) 497-9163
- NPI assigned
- Feb 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P013735 | NC | Primary |
Addresses
Primary practice location
1 Hospital Rd
Caller Box C-268
Cherokee, NC 28719-2871
Mailing address
1 Hospital Rd
Caller Box C-268
Cherokee, NC 28719
Phone (828) 497-9163
Other practice location 1
375 Sequoyah Trail
Caller Box C-268
Cherokee, NC 28719-2871
Phone (828) 497-9163
Other names 1
- Nicole St. Charles
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Cherokee |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P013735 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582761600000",
"number": "1669006730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HOSPITAL RD",
"address_2": "CALLER BOX C-268",
"city": "CHEROKEE",
"state": "NC",
"postal_code": "28719",
"telephone_number": "828-497-9163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HOSPITAL RD",
"address_2": "CALLER BOX C-268",
"city": "CHEROKEE",
"state": "NC",
"postal_code": "287192871",
"telephone_number": "828-497-9163"
}
],
"practiceLocations": [
{
"address_1": "375 Sequoyah Trail",
"address_2": "Caller Box C-268",
"address_purpose": "LOCATION",
"city": "Cherokee",
"state": "NC",
"postal_code": "287192871",
"country_code": "US",
"telephone_number": "828-497-9163",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOUDREAUX",
"first_name": "NICOLE",
"credential": "LCSWA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-27",
"last_updated": "2020-02-27",
"certification_date": "2020-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P013735",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Cherokee",
"affiliation": "N",
"address_1": "1 Hospital Rd",
"address_2": "Caller Box C-268",
"city": "Cherokee",
"state": "NC",
"country_code": "US",
"postal_code": "287192871",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "ST. CHARLES",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cherokee, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.