Dr. Edwin D Boudreaux, PHD
Psychologist, Clinical in Worcester, Massachusetts
1790873768- Practice location
- 55 Lake Ave N, Worcester, MA 01655-0002
- Phone
- 508-334-3817
- Fax
- —
- Last updated
- January 25, 2017
Edwin D Boudreaux is a Psychologist, Clinical based in Worcester, MA. Edwin D Boudreaux practices in Worcester, MA and has the professional credentials of PHD. The NPI Number for Edwin D Boudreaux is 1790873768 and holds a License No. 9227 (MA). The current practice location address for Edwin D Boudreaux is 55 Lake Ave N, Worcester, MA 01655-0002 and can be reached out via phone at 508-334-3817.
Provider Profile Details
- NPI Number
- 1790873768
- Provider Name
- Edwin D Boudreaux
- Credential
- PHD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 55 Lake Ave N, Worcester, MA 01655-0002
- Phone Number
- 508-334-3817
- Primary Taxonomy
- Psychologist, Clinical · 103TC0700X
- Sole Proprietor
- No
- Provider Enumeration Date
- October 11, 2006
- Last Update Date
- January 25, 2017
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 55 Lake Ave N
Worcester, MA 01655-0002 - City
- Worcester
- State
- Massachusetts
- Zip
- 01655-0002
- Phone Number
- 508-334-3817
Provider Business Mailing Address Details
- Address
- Po Box 415348
Boston, MA 02241-5348 - City
- Boston
- State
- MA
- Zip
- 02241-5348
- Phone Number
- 800-225-8885
- Fax Number
- 508-334-1977
License Information
- License Number
- 9227
- License State
- MA
- Taxonomy
- Psychologist, Clinical · 103TC0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Edwin D Boudreaux, PHD?
The NPI number of Dr. Edwin D Boudreaux, PHD is 1790873768. It was assigned on October 11, 2006 and is currently active in the NPPES registry.
What is the specialty of Dr. Edwin D Boudreaux, PHD?
Dr. Edwin D Boudreaux, PHD is registered under the primary taxonomy Psychologist, Clinical (code 103TC0700X), licensed in MA under license number 9227.
Where does Dr. Edwin D Boudreaux, PHD practice?
The practice location is 55 Lake Ave N, Worcester, MA 01655-0002. The office can be reached at 508-334-3817 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1790873768 directly on the NPPES registry website.