Provider Demographics
NPI:1235588872
Name:BOYLAN, DANIEL (LPC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BOYLAN
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 1:373 CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2218
Mailing Address - Country:US
Mailing Address - Phone:706-229-2211
Mailing Address - Fax:
Practice Address - Street 1:2565 THOMPSON BRIDGE RD STE 111
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1723
Practice Address - Country:US
Practice Address - Phone:706-229-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008488101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional