Provider Demographics
NPI:1215294665
Name:BOYLE, MARY MARGARET (LPC, LCADC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:MARGARET
Last Name:BOYLE
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1631
Mailing Address - Country:US
Mailing Address - Phone:908-247-0630
Mailing Address - Fax:
Practice Address - Street 1:1002 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1631
Practice Address - Country:US
Practice Address - Phone:908-247-0630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NJ37LC00316100101YA0400X
NJ37PC00667900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)