Provider Demographics
NPI:1053092320
Name:BOENING, EMILY (LPC-A, NCC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BOENING
Suffix:
Gender:F
Credentials:LPC-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 STATE ST APT 208
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-7104
Mailing Address - Country:US
Mailing Address - Phone:336-301-3234
Mailing Address - Fax:
Practice Address - Street 1:801 GERVAIS ST STE 2B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3125
Practice Address - Country:US
Practice Address - Phone:803-888-6714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8499101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health