Provider Demographics
NPI:1700254919
Name:BOYLE, DONALD ANTHONY (LPC)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:ANTHONY
Last Name:BOYLE
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 1:13359 HWY 155 S
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-6554
Mailing Address - Country:US
Mailing Address - Phone:903-266-1030
Mailing Address - Fax:
Practice Address - Street 1:13359 HWY 155 S
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-6554
Practice Address - Country:US
Practice Address - Phone:903-266-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70586101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional