Active NPI
Camry Boudy
- Mental Health Counselor
- Houston, TX
National Provider Identifier
1962952903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 86103
- Practice address
- 4411 Dacoma St
Houston, TX 77092-8611 - Phone
- (713) 686-9194
- Fax
- (713) 686-9413
- NPI assigned
- Oct 13, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Mental Health Counselor | 101YM0800X | 86103 | TX | Primary |
Addresses
Primary practice location
4411 Dacoma St
Houston, TX 77092-8611
Mailing address
111 Oak St
McComb, MS 39648-3736
Phone (985) 707-3961
Other practice location 1
111 Oak St
McComb, MS 39648-3736
Phone (985) 707-3961
Other practice location 2
4131 Spicewood Springs Rd Ste J1
Austin, TX 78759-8600
Phone (713) 686-9194
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707955200000",
"number": "1962952903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 OAK ST",
"city": "MCCOMB",
"state": "MS",
"postal_code": "396483736",
"telephone_number": "985-707-3961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4411 DACOMA ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770928611",
"telephone_number": "713-686-9194",
"fax_number": "713-686-9413"
}
],
"practiceLocations": [
{
"address_1": "111 Oak St",
"address_purpose": "LOCATION",
"city": "McComb",
"state": "MS",
"postal_code": "396483736",
"country_code": "US",
"telephone_number": "985-707-3961",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4131 Spicewood Springs Rd Ste J1",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787598600",
"country_code": "US",
"telephone_number": "713-686-9194",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOUDY",
"first_name": "CAMRY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-13",
"last_updated": "2024-02-15",
"certification_date": "2024-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "86103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.