Provider Demographics
NPI:1154485886
Name:BOSTON, WILLIAM BERNARD (LPC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BERNARD
Last Name:BOSTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3319 14TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2902
Mailing Address - Country:US
Mailing Address - Phone:202-415-2158
Mailing Address - Fax:
Practice Address - Street 1:1012 14TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3403
Practice Address - Country:US
Practice Address - Phone:202-737-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPR962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health