Provider Demographics
NPI:1821492190
Name:BOAK, STEPHANIE HUGHES (MED, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:HUGHES
Last Name:BOAK
Suffix:
Gender:F
Credentials:MED, LMHC
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Mailing Address - Street 1:208 E 25TH STREET
Mailing Address - Street 2:NW FAMILY PSYCHOLOGY, LLC
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-3129
Mailing Address - Country:US
Mailing Address - Phone:360-910-1522
Mailing Address - Fax:360-326-1522
Practice Address - Street 1:208 E 25TH STREET
Practice Address - Street 2:NW FAMILY PSYCHOLOGY, LLC
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3129
Practice Address - Country:US
Practice Address - Phone:360-910-1522
Practice Address - Fax:360-326-1522
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALN60705301101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor