Provider Demographics
NPI:1982929873
Name:BOYLE, VINCENTINA (LPC)
Entity Type:Individual
Prefix:MS
First Name:VINCENTINA
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 TICKTON HALL RD
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-7720
Mailing Address - Country:US
Mailing Address - Phone:843-726-8193
Mailing Address - Fax:843-815-8573
Practice Address - Street 1:10 PINCKNEY COLONY RD
Practice Address - Street 2:BUILDING 300 SUITE 301
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-4126
Practice Address - Country:US
Practice Address - Phone:843-726-8193
Practice Address - Fax:843-815-8573
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5086101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional