Provider Demographics
NPI:1225104276
Name:BOYER, DENNIS M (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:M
Last Name:BOYER
Suffix:
Gender:M
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 362
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-0362
Mailing Address - Country:US
Mailing Address - Phone:609-909-3797
Mailing Address - Fax:
Practice Address - Street 1:5616 DOUGHBOY LOOP
Practice Address - Street 2:
Practice Address - City:JB MDL
Practice Address - State:NJ
Practice Address - Zip Code:08640-5429
Practice Address - Country:US
Practice Address - Phone:609-412-6366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00062200101YA0400X
NJ44SC053033001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)