Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jerry Paul Boudreaux, LCSW

Individual provider Clinical Social Worker · NPI 1366515702

Mr. Jerry Paul Boudreaux, LCSW is a Clinical Social Worker in Gulfport, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.

Licensed in
MS
In the registry since
2006
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

549 E Pass Rd Ste P
Gulfport, MS 39507-3261
Phone: (228) 896-9251
Fax: (228) 897-6003
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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 0058 (MS)

Record details

NPI number1366515702
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedNovember 15, 2006
Last updated in NPPESJuly 8, 2007

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