Provider Demographics
NPI:1992382444
Name:BOYMEL, EVAN (CDCA)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:BOYMEL
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7858 WILD ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4307
Mailing Address - Country:US
Mailing Address - Phone:513-292-4155
Mailing Address - Fax:
Practice Address - Street 1:12500 REED HARTMAN HWY STE 130
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-1951
Practice Address - Country:US
Practice Address - Phone:513-292-4155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)