Provider Demographics
NPI:1376743732
Name:FLEMMING, BOMAN SCOTT (MED, LPC)
Entity Type:Individual
Prefix:MR
First Name:BOMAN
Middle Name:SCOTT
Last Name:FLEMMING
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 MONTGOMERY HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1844
Mailing Address - Country:US
Mailing Address - Phone:205-868-9617
Mailing Address - Fax:205-868-9600
Practice Address - Street 1:550 MONTGOMERY HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-1844
Practice Address - Country:US
Practice Address - Phone:205-868-9617
Practice Address - Fax:205-868-9600
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2316101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional