Active NPI
Agyenim Akuamoah-Boateng, LPC
- Professional Counselor
- Laurinburg, NC
National Provider Identifier
1306844352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3685
- Practice address
- 911 Atkinson St
Laurinburg, NC 28352-4718 - Phone
- (910) 291-9909
- Fax
- (910) 291-9913
- NPI assigned
- Jul 13, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3685 | NC | Primary |
Addresses
Primary practice location
911 Atkinson St
Laurinburg, NC 28352-4718
Mailing address
3 Canter PL
Pinehurst, NC 28374-8675
Phone (910) 295-3257
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6102339 | Medicaid | NC | |
| 6102025 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3685 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1306844352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 CANTER PL",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283748675",
"telephone_number": "910-295-3257",
"fax_number": "910-291-9913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 ATKINSON ST",
"city": "LAURINBURG",
"state": "NC",
"postal_code": "283524718",
"telephone_number": "910-291-9909",
"fax_number": "910-291-9913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AKUAMOAH-BOATENG",
"first_name": "AGYENIM",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-13",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "3685",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6102339",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6102025",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Laurinburg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.