Provider Demographics
NPI:1417694258
Name:LAUREN MAZOW BOYLE, PH.D., LLC
Entity Type:Organization
Organization Name:LAUREN MAZOW BOYLE, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:MAZOW
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-674-5880
Mailing Address - Street 1:11325 SEVEN LOCKS RD STE 279B
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3205
Mailing Address - Country:US
Mailing Address - Phone:301-674-5880
Mailing Address - Fax:
Practice Address - Street 1:11325 SEVEN LOCKS RD STE 279B
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3205
Practice Address - Country:US
Practice Address - Phone:301-674-5880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)