MS. TRACY L BOUDRIE RSST MA LPC NPI 1205252129

NPI Information

NPI: 1205252129
Provider Name: MS. TRACY L BOUDRIE, RSST, MA, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
62 W 7 MILE RD
DETROIT, MI
ZIP 48203
Phone: (313) 893-6172
Get Directions

MS. Tracy L Boudrie, RSST, MA, LPC is a professional counselor in Detroit, MI. MS. Tracy L Boudrie, RSST, MA, LPC NPI is 1205252129. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

62 W 7 MILE RD
DETROIT, MI
ZIP 48203-967
Phone: (313) 893-6172
Fax: (313) 893-0064

The enumeration date for this NPI number is 3/17/2014 and was last updated on 12/1/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		6401015444	MICHIGAN	No
2	171M00000X	Case Manager/Care Coordinator		6803086484	MICHIGAN	No
3	101YP2500X	Counselor	Professional	6401017135	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6401015444	OTHER	MICHIGAN	LLPC
2	6401017135	OTHER	MICHIGAN	LPC
3	6803086484	OTHER	MICHIGAN	REGISTERED SOCIAL SERVICE TECHNICIAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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