Provider Demographics
NPI:1437138138
Name:BOYKO, REBECCA (LICSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BOYKO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:178 SAVIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-2329
Mailing Address - Country:US
Mailing Address - Phone:781-338-7273
Mailing Address - Fax:781-338-7245
Practice Address - Street 1:178 SAVIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-2329
Practice Address - Country:US
Practice Address - Phone:781-338-7273
Practice Address - Fax:781-338-7245
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1130311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2314894OtherCIGNABEHAVIORAL HEALTH
MAP 08588OtherBLUE CROSS
MA2314894OtherCIGNABEHAVIORAL HEALTH