MEDICARE: ELIZABETH BOYAJIAN M.ED, LMHC LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	144	MA
2	101YP2500X	Professional Counselor	3300	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LM1258	OTHER	MA	BLUE CROSSBLUE SHIELD
2	2649500	OTHER		CIGNA BEHAVIORAL HEALTH

General Provider Information

NPI Number	:	1447239009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH BOYAJIAN M.ED, LMHC LCPC

Provider Business Mailing Address
First Line	:	1 ANGEL PL
Second Line	:
City	:	BATH
State	:	ME
Zip	:	04530-1691
Country	:	US
Telephone Number	:	207-505-0777
Fax Number	:	207-729-7277

Provider Business Practice Location Address
First Line	:	63 E ELM STREET
Second Line	:	FELDSPAR MILL
City	:	TOPSHAM
State	:	ME
Zip	:	04086
Country	:	US
Telephone Number	:	207-505-0777
Fax Number	:	207-729-7277

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	11/10/2008

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