Provider Demographics
NPI:1225852379
Name:BOYER-SEME, MALAIKA M (MS, LPCA)
Entity type:Individual
Prefix:MRS
First Name:MALAIKA
Middle Name:M
Last Name:BOYER-SEME
Suffix:
Gender:F
Credentials:MS, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HALES CT
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-6130
Mailing Address - Country:US
Mailing Address - Phone:203-434-6522
Mailing Address - Fax:
Practice Address - Street 1:1 ENTERPRISE DR STE 415
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4631
Practice Address - Country:US
Practice Address - Phone:203-434-6522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
CT4652101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral