Provider Demographics
NPI:1689160475
Name:BOATENG, AMMA K (MED, LPC, NCC)
Entity type:Individual
Prefix:
First Name:AMMA
Middle Name:K
Last Name:BOATENG
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7611 MAPLE ST STE A8
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5068
Mailing Address - Country:US
Mailing Address - Phone:504-475-7808
Mailing Address - Fax:
Practice Address - Street 1:7611 MAPLE ST STE A8
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5068
Practice Address - Country:US
Practice Address - Phone:504-475-7808
Practice Address - Fax:504-446-7780
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-05
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74772101YP2500X
LA8257101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty