Provider Demographics
NPI:1720102551
Name:BOICE, DONALD LAWRENCE (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:LAWRENCE
Last Name:BOICE
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SCHOLFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-4211
Mailing Address - Country:US
Mailing Address - Phone:585-544-2547
Mailing Address - Fax:
Practice Address - Street 1:240 RIDGE RD E
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1310
Practice Address - Country:US
Practice Address - Phone:585-544-2547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0577521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical