Provider Demographics
NPI:1437468600
Name:APPIAH-BOATENG, ALLEN KOFI
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:KOFI
Last Name:APPIAH-BOATENG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5823
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78683-5823
Mailing Address - Country:US
Mailing Address - Phone:512-547-6193
Mailing Address - Fax:866-496-5011
Practice Address - Street 1:3701 QUICK HILL ROAD
Practice Address - Street 2:APT 9307
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-1285
Practice Address - Country:US
Practice Address - Phone:512-547-6193
Practice Address - Fax:866-496-5011
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 101YA0400X
TX75908101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)