Provider Demographics
NPI:1033225719
Name:BOYCE, WILLIAM KENNER (LPC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:KENNER
Last Name:BOYCE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5649 S FARM ROAD 163
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-2972
Mailing Address - Country:US
Mailing Address - Phone:417-882-9179
Mailing Address - Fax:
Practice Address - Street 1:5649 S FARM ROAD 163
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-2972
Practice Address - Country:US
Practice Address - Phone:417-882-9179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCS001089101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor