Freddie Boan, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

10330 Issued in SC

Practice address

12688 Main St
Williston, SC 29853-2706

Phone

(803) 507-1890

NPI assigned

Oct 24, 2024

Last updated

Oct 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1821819509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12688 MAIN ST",
            "city": "WILLISTON",
            "state": "SC",
            "postal_code": "298532706",
            "telephone_number": "803-507-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12688 MAIN ST",
            "city": "WILLISTON",
            "state": "SC",
            "postal_code": "298532706",
            "telephone_number": "803-507-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAN",
        "first_name": "FREDDIE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "10330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barnwell County Hospital (Williston Family Practice)
• Barnwell County Hospital (Williston Family Practice)
• Barnwell School District #29
• Bates Family Hair Affair, LLC
• Bates Family Hair Affair, LLC
• Tasha Michelle Bowman, ATC
• Carlyle Senior Care of Williston LLC (Carlyle Senior Care of Williston)
• Carolina Rural Practice Management, Inc. (Williston Medical Center)
• Elise Faulkner
• Cheryl Lee Gentry, PTA

• Counselor in Williston, SC
• Providers in Williston, SC by specialty
• Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.