Provider Demographics
NPI:1346920063
Name:BOATMAN, JAMES D (LMSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:BOATMAN
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4590 S DESERT WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-5718
Mailing Address - Country:US
Mailing Address - Phone:760-580-4731
Mailing Address - Fax:
Practice Address - Street 1:8222 S 48TH ST STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5303
Practice Address - Country:US
Practice Address - Phone:520-640-7189
Practice Address - Fax:866-900-9080
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-22505104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker