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Dr. Manijeh Boustani, PHD
Psychologist in Wilson, North Carolina
NPI 1134215031

Manijeh Boustani is a Psychologist based in Raleigh, NC. Manijeh Boustani practices in Wilson, NC and has the professional credentials of PHD. The NPI Number for Manijeh Boustani is 1134215031 and holds a License No. 1456 (North Carolina).

The current practice location address for Manijeh Boustani is 2401 Wooten Blvd Sw Ste K, Wilson, NC and can be reached out via phone at 252-291-0735 and via fax at 252-291-2890. You can also correspond with Manijeh Boustani through the mailing address at 608 PENNCROSS DR, RALEIGH, NC - 27610-2177 (mailing address contact number: 919-656-3589).

Location: 2401 Wooten Blvd Sw Ste K, Wilson, NC, 27610-2177
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1134215031
Provider Name
Manijeh Boustani
Credential
PHD
Provider Entity Type
Individual
Gender
Female
Address
2401 Wooten Blvd Sw Ste K, Wilson, NC, 27610-2177
Phone Number
252-291-0735
Fax Number
252-291-2890
Provider Enumeration Date
10/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6000721 05 NC
6000563 05 NC
0416L 01 NC BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
2401 Wooten Blvd Sw Ste K
City
Wilson
State
North Carolina
Zip
27893-4464
Phone Number
252-291-0735
Fax Number
252-291-2890
person
Provider Business Mailing Address Details
Address
608 Penncross Dr
City
Raleigh
State
North Carolina
Zip
27610-2177
Phone Number
919-656-3589
Fax Number
919-243-0923
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
-
Taxonomy
103T00000X
License No.
1456 (North Carolina)
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
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