Provider Demographics
NPI:1194862995
Name:BOADI, AKYENAA K (LPC)
Entity Type:Individual
Prefix:
First Name:AKYENAA
Middle Name:K
Last Name:BOADI
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 1:6 MARTIN CT
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-2039
Mailing Address - Country:US
Mailing Address - Phone:314-972-6244
Mailing Address - Fax:
Practice Address - Street 1:6 MARTIN CT
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-2039
Practice Address - Country:US
Practice Address - Phone:314-972-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001001597101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional