Michelle L Boudreaux, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801073431 Issued in MI

Practice address

1131 Ionia NW
Grand Rapids, MI 49503

Phone

(616) 259-7900

Fax

(269) 381-3810

NPI assigned

Aug 24, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle L Boudreaux Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841307006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 SOUTH BURDICK STREET",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49007",
            "telephone_number": "269-488-9691",
            "fax_number": "269-381-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 IONIA NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-259-7900",
            "fax_number": "269-381-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801073431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "BOUDREAUX",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charity Bouchard, PA
• Kristin D. Bouche, CRNA
• Christina Boucher
• Sarah Boucher
• Carolyn Elizabeth Boudreaux, M.A., CCC-SLP
• Sarah Boulerice
• Hany Boulos, DDS
• Christopher Michael Bouma, DNP, AGPCNP-BC, RN
• Douglas A Bouman, PSYSLLP
• Kristin Bouman

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.