Individual
MR. DAVID S BOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
2200 LAKE VICTORIA DR, SPRINGFIELD, IL 62703-5596
(217) 529-9266
(217) 529-9151
Mailing address
3008 HAPPY LANDING DR, SPRINGFIELD, IL 62711-6259
(217) 318-5539
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180014182
IL
101YP2500X
Professional Counselor
178014846
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178014846
STATE LICENSE
IL
Enumeration date
10/14/2019
Last updated
02/28/2022
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