Provider Demographics
NPI:1326173923
Name:BOYER, RICHARD LOUIS (LPC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LOUIS
Last Name:BOYER
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 1:1419 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-3763
Mailing Address - Country:US
Mailing Address - Phone:903-654-7591
Mailing Address - Fax:903-874-3036
Practice Address - Street 1:122 S 12TH ST STE 102
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-5261
Practice Address - Country:US
Practice Address - Phone:903-654-7591
Practice Address - Fax:903-874-3036
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152099101Medicaid