Provider Demographics
NPI:1316477722
Name:BOYCE, CIERRA (LCSW)
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:BOYCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-1189
Mailing Address - Country:US
Mailing Address - Phone:575-746-9848
Mailing Address - Fax:575-746-9840
Practice Address - Street 1:1105 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-1189
Practice Address - Country:US
Practice Address - Phone:575-746-9848
Practice Address - Fax:575-746-9840
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2024-11-19
Deactivation Date:2023-10-24
Deactivation Code:
Reactivation Date:2023-12-04
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 1041C0700X
NMSWB-2023-1144104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR60350064OtherBLUE CROSS BLUE SHIELD