Provider Demographics
NPI:1689436461
Name:HAYMSON, BORIS ABRAMS (PHD, LPCC, LADC)
Entity Type:Individual
Prefix:
First Name:BORIS
Middle Name:ABRAMS
Last Name:HAYMSON
Suffix:
Gender:M
Credentials:PHD, LPCC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14473 QUEBEC AVE
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2556
Mailing Address - Country:US
Mailing Address - Phone:952-200-8262
Mailing Address - Fax:
Practice Address - Street 1:14473 QUEBEC AVE
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2556
Practice Address - Country:US
Practice Address - Phone:952-200-8262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN303387101YA0400X
MN507401101YS0200X
MNCC00013101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool