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General NPI Number Information
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NPI Number | 1073470589
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Entity Type | Individual
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Provider Name | CARLY MADISON BOENS MS
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Gender | Female
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 3119 GOLF RD STE 107
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City | EAU CLAIRE
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State | WI
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Zip | 54701-7073
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Country | US
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Telephone | 715-201-4209
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Fax | 888-423-1002
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Provider Business Mailing Address
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Address Line | 3119 GOLF RD STE 107
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City | EAU CLAIRE
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State | WI
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Zip | 54701-7073
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Country | US
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Telephone | 715-201-4209
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Fax | 888-423-1002
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8825-226
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License Number State | WI
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