Provider Demographics
NPI:1710378054
Name:BOUGHER, EMILY (LPC-CR)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BOUGHER
Suffix:
Gender:F
Credentials:LPC-CR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 DUBLIN RD
Mailing Address - Street 2:SUITE 208D
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1000
Mailing Address - Country:US
Mailing Address - Phone:614-538-0353
Mailing Address - Fax:614-429-3219
Practice Address - Street 1:1335 DUBLIN RD
Practice Address - Street 2:SUITE 208D
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1000
Practice Address - Country:US
Practice Address - Phone:614-538-0353
Practice Address - Fax:614-429-3219
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1300621101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional