Boudouris, George

Boudouris, George is an sole proprietor health care provider with primary practice located at 934 E Jefferson St , Charlottesville VA 22902-5326. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Boudouris, George can be contacted via phone (434) 984-2200.

Contact Information

Primary practice address
934 E Jefferson St Charlottesville VA 22902-5326
Phone: (434) 984-2200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810002895 Virginia

Profile Details

NPI number 1447280383
LBN Legal business name Boudouris, George
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 4th, 2006
Last updated Mar 24th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447280383 NPPES
Virginia Other 345410000 MAGELLAN
Virginia MEDICAID 7704925 MAGELLAN
Virginia Other 084692 MAGELLAN
Virginia Other 472808 MAGELLAN
Virginia Other 7685432 MAGELLAN
Virginia Other 435591 MAGELLAN

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