Individual
SHERRY BOULDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4500 I 55 N, SUITE 220, JACKSON, MS 39211-5930
(601) 927-8729
Mailing address
PO BOX 12195, JACKSON, MS 39236-2195
(601) 292-6260
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1995
MS
101YM0800X
Mental Health Counselor
1995
MS
101YP2500X
Professional Counselor
Primary
1995
MS
102L00000X
Psychoanalyst
1995
MS
103K00000X
Behavior Analyst
1995
MS
Other
Enumeration date
11/01/2015
Last updated
09/17/2025
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