Provider Demographics
NPI:1689190399
Name:AKOURY, LIYA MARKOVNA (PHD)
Entity Type:Individual
Prefix:
First Name:LIYA
Middle Name:MARKOVNA
Last Name:AKOURY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LIYA
Other - Middle Name:MARKOVNA
Other - Last Name:RAKHKOVSKAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:112 WATER ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4206
Mailing Address - Country:US
Mailing Address - Phone:617-315-8856
Mailing Address - Fax:
Practice Address - Street 1:112 WATER ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4206
Practice Address - Country:US
Practice Address - Phone:617-315-8856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11346103TC0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical