Provider Demographics
NPI:1659370278
Name:BOYLE, KATE (PSY D, LP)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:PSY D, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 CLEVELAND AVE S STE A7
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-1200
Mailing Address - Country:US
Mailing Address - Phone:651-698-3393
Mailing Address - Fax:888-978-4418
Practice Address - Street 1:241 CLEVELAND AVE S STE A7
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-1200
Practice Address - Country:US
Practice Address - Phone:651-698-3393
Practice Address - Fax:888-978-4418
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4428103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN50957B0OtherBC/BS
MN261948200Medicaid