Provider Demographics
NPI:1326600198
Name:BOAMAH, TAYLOR ASHLEE (LPC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ASHLEE
Last Name:BOAMAH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8350 RICHMOND HWY STE 415
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2345
Mailing Address - Country:US
Mailing Address - Phone:703-704-6355
Mailing Address - Fax:703-653-6613
Practice Address - Street 1:8350 RICHMOND HWY STE 415
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-2345
Practice Address - Country:US
Practice Address - Phone:703-704-6355
Practice Address - Fax:703-653-6613
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional