Provider Demographics
NPI:1942862669
Name:BOYLE CIERI, MAUREEN SANDRA (LPC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:SANDRA
Last Name:BOYLE CIERI
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 1:398 N STATE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-1334
Mailing Address - Country:US
Mailing Address - Phone:610-322-6305
Mailing Address - Fax:
Practice Address - Street 1:133 COULTER AVE STE 1
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2416
Practice Address - Country:US
Practice Address - Phone:215-883-4161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011298101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor