Provider Demographics
NPI:1225456023
Name:BOARTS, JOSEPH (LMHC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:BOARTS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 BAYOU BLVD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4339
Mailing Address - Country:US
Mailing Address - Phone:850-816-6510
Mailing Address - Fax:
Practice Address - Street 1:4300 BAYOU BLVD STE 21
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2671
Practice Address - Country:US
Practice Address - Phone:850-816-6510
Practice Address - Fax:850-816-6510
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14563101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health