Provider Demographics
NPI:1598311037
Name:BOYER, ANDRE JR (CIT)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:
Last Name:BOYER
Suffix:JR
Gender:M
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 AMBASSADOR CAFFERY PKWY APT 100
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-5933
Mailing Address - Country:US
Mailing Address - Phone:318-305-7642
Mailing Address - Fax:
Practice Address - Street 1:2700 AMBASSADOR CAFFERY PKWY APT 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-5933
Practice Address - Country:US
Practice Address - Phone:318-305-7642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator