Healthcare Provider Details

I. General information

NPI: 1881054591
Provider Name (Legal Business Name): VIRGINIA M. BONEY, PH.D. LMFT, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 GOOD HOPE RD
BLUFFTON SC
29909-3108
US

IV. Provider business mailing address

321 GOOD HOPE RD
BLUFFTON SC
29909-3108
US

V. Phone/Fax

Practice location:
  • Phone: 904-236-3963
  • Fax:
Mailing address:
  • Phone: 904-236-3963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT1924
License Number StateFL

VIII. Authorized Official

Name: VIRGINIA M BONEY
Title or Position: PRESIDENT
Credential:
Phone: 904-236-3963