Provider Demographics
NPI:1386209245
Name:BOICE COUNSELING LCSW PC
Entity Type:Organization
Organization Name:BOICE COUNSELING LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOICE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:585-802-1273
Mailing Address - Street 1:572 TITUS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3519
Mailing Address - Country:US
Mailing Address - Phone:585-544-5342
Mailing Address - Fax:585-266-9336
Practice Address - Street 1:572 TITUS AVE STE B
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3519
Practice Address - Country:US
Practice Address - Phone:585-544-5342
Practice Address - Fax:585-266-9336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)