Provider Demographics
NPI:1386499242
Name:BOAGNI, ALYSHIA B (LPC)
Entity type:Individual
Prefix:MRS
First Name:ALYSHIA
Middle Name:B
Last Name:BOAGNI
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:PO BOX 1191
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70571-1191
Mailing Address - Country:US
Mailing Address - Phone:337-351-4861
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1191
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70571-1191
Practice Address - Country:US
Practice Address - Phone:337-351-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7564101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty