Provider Demographics
NPI:1144547084
Name:BOYINGTON, VERNA JO (LCPCC)
Entity type:Individual
Prefix:MRS
First Name:VERNA
Middle Name:JO
Last Name:BOYINGTON
Suffix:
Gender:F
Credentials:LCPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 ENFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457-4137
Mailing Address - Country:US
Mailing Address - Phone:207-794-8541
Mailing Address - Fax:
Practice Address - Street 1:313 ENFIELD ROAD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ME
Practice Address - Zip Code:04457-4137
Practice Address - Country:US
Practice Address - Phone:207-794-8541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL3587101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional