Provider Demographics
NPI:1194923870
Name:BOLAND, BARBARA ANNE (LPC)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANNE
Last Name:BOLAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 BRIDGE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-5214
Mailing Address - Country:US
Mailing Address - Phone:843-572-4217
Mailing Address - Fax:
Practice Address - Street 1:196 BRIDGE CREEK DR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-5214
Practice Address - Country:US
Practice Address - Phone:843-572-4217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2130101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health