Provider Demographics
NPI:1982636767
Name:BOYE, EDWARD LEE (LPC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:LEE
Last Name:BOYE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 LAKEVIEW PT
Mailing Address - Street 2:
Mailing Address - City:TURTLETOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37391-4818
Mailing Address - Country:US
Mailing Address - Phone:423-496-9878
Mailing Address - Fax:
Practice Address - Street 1:101 RIVERSTONE VIS
Practice Address - Street 2:SUITE 201A
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-6648
Practice Address - Country:US
Practice Address - Phone:423-496-9878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA249101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA249OtherLISCENCED PROFESSIONAL CO