Provider Demographics
NPI:1780805333
Name:BOYLE, KATHERINE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478
Mailing Address - Country:US
Mailing Address - Phone:781-438-8393
Mailing Address - Fax:978-233-4925
Practice Address - Street 1:36 WOBURN ST #6
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867
Practice Address - Country:US
Practice Address - Phone:781-438-8393
Practice Address - Fax:978-233-4925
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA778220OtherTUFTS
MA1891197Medicaid
MAP06110OtherBLUE CROSS