Provider Demographics
NPI:1750635421
Name:BOYLAND, CHERYL (LPC-S, NCC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:BOYLAND
Suffix:
Gender:F
Credentials:LPC-S, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 W GREEN OAKS BLVD
Mailing Address - Street 2:SUITE 305-162
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-4462
Mailing Address - Country:US
Mailing Address - Phone:817-412-9397
Mailing Address - Fax:817-394-1909
Practice Address - Street 1:4101 W GREEN OAKS BLVD
Practice Address - Street 2:SUITE 305-162
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4462
Practice Address - Country:US
Practice Address - Phone:817-412-9397
Practice Address - Fax:817-394-1909
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63738101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional