Provider Demographics
NPI:1689123762
Name:BOYER, ROSEANNA FERN (LPC)
Entity Type:Individual
Prefix:
First Name:ROSEANNA
Middle Name:FERN
Last Name:BOYER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40715
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-0110
Mailing Address - Country:US
Mailing Address - Phone:541-344-7088
Mailing Address - Fax:888-990-2234
Practice Address - Street 1:215 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3008
Practice Address - Country:US
Practice Address - Phone:541-344-7088
Practice Address - Fax:888-990-2234
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16-07-05101YA0400X
OR16 07 05U101YA0400X
ORR5962101YM0800X
ORC7340101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)