Provider Demographics
NPI:1316755937
Name:BOYETT, MAVERYCK (LCSW)
Entity type:Individual
Prefix:
First Name:MAVERYCK
Middle Name:
Last Name:BOYETT
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 1:4800 E CHERRY CREEK SOUTH DR APT L102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2296
Mailing Address - Country:US
Mailing Address - Phone:303-335-0106
Mailing Address - Fax:
Practice Address - Street 1:225 S BROADWAY ST #9950
Practice Address - Street 2:#SMB32654
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209
Practice Address - Country:US
Practice Address - Phone:303-335-0106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099296241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical