Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jeremy Paul Boudreaux, LCSW

Individual provider Clinical Social Worker · NPI 1790247757

Mr. Jeremy Paul Boudreaux, LCSW is a Clinical Social Worker in Madison, Wisconsin. Licensed in Illinois and Wisconsin. Registered with an NPI since 2019.

Licensed in
IL, WI
In the registry since
2019
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

615 N Sherman Ave Ste 24
Madison, WI 53704-4457
Phone: (608) 445-2510
Fax: (262) 293-9777
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 10072-123 (WI)
Clinical Social Worker Taxonomy 1041C0700X · Licence 22128 (WI)
Clinical Social Worker Taxonomy 1041C0700X · Licence 149020671 (IL)

Record details

NPI number1790247757
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedApril 1, 2019
Last updated in NPPESApril 23, 2024
Certification dateApril 23, 2024

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