Provider Demographics
NPI:1861023798
Name:BOSTON, ASHANTI REGINA (LMHC, LPC, LCPC)
Entity type:Individual
Prefix:
First Name:ASHANTI
Middle Name:REGINA
Last Name:BOSTON
Suffix:
Gender:F
Credentials:LMHC, LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 OLD GALLOWS RD STE 515
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3931
Mailing Address - Country:US
Mailing Address - Phone:347-605-4382
Mailing Address - Fax:
Practice Address - Street 1:1945 OLD GALLOWS RD STE 515
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3931
Practice Address - Country:US
Practice Address - Phone:571-568-8794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011811101YM0800X
MDLC15988101YP2500X
VA0701013573101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional