Individual provider Active NPI

Camry Boudy

  • Mental Health Counselor
  • Houston, TX
National Provider Identifier
1962952903
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
86103 Issued in TX
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

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.