Provider Demographics
NPI:1629170055
Name:BOYETT, NANCY ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:ELIZABETH
Last Name:BOYETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5750A SOUTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-3316
Mailing Address - Country:US
Mailing Address - Phone:251-660-2360
Mailing Address - Fax:251-662-7297
Practice Address - Street 1:24190 US HIGHWAY 98 STE D
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-3342
Practice Address - Country:US
Practice Address - Phone:251-660-2360
Practice Address - Fax:251-662-7297
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1340-C1041C0700X
MI68011151571041C0700X
AL2327C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5U905Medicare UPIN