Provider Demographics
NPI:1366538043
Name:BOVA, JOHN ALAN (LPC, LICDC, CNP-BC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ALAN
Last Name:BOVA
Suffix:
Gender:M
Credentials:LPC, LICDC, CNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 NEWARK RD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2618
Mailing Address - Country:US
Mailing Address - Phone:740-260-2068
Mailing Address - Fax:
Practice Address - Street 1:1175 NEWARK RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2618
Practice Address - Country:US
Practice Address - Phone:740-260-2068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC6794101Y00000X
OH976194101YA0400X
OH10308363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)