Provider Demographics
NPI:1104550375
Name:BOYLES FAMILY COUNSELING, LLC
Entity type:Organization
Organization Name:BOYLES FAMILY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYLES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:405-531-0726
Mailing Address - Street 1:407 W COVELL RD UNIT 30903
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-2242
Mailing Address - Country:US
Mailing Address - Phone:405-531-0726
Mailing Address - Fax:405-607-1750
Practice Address - Street 1:401 E MEMORIAL RD STE 500
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-2287
Practice Address - Country:US
Practice Address - Phone:405-531-0726
Practice Address - Fax:405-607-1750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK8624OtherLCSW