Provider Demographics
NPI:1154122877
Name:O'BOYLE, KEVIN THOMAS MICHAEL
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:THOMAS MICHAEL
Last Name:O'BOYLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 LINCOLN HWY E
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-3347
Mailing Address - Country:US
Mailing Address - Phone:717-397-7625
Mailing Address - Fax:
Practice Address - Street 1:1929 LINCOLN HWY E
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3347
Practice Address - Country:US
Practice Address - Phone:717-397-7625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor