Provider Demographics
NPI:1386618254
Name:BOYETT, DONETTE (LCSW-A)
Entity type:Individual
Prefix:MRS
First Name:DONETTE
Middle Name:
Last Name:BOYETT
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AR
Mailing Address - Zip Code:72565
Mailing Address - Country:US
Mailing Address - Phone:501-315-3344
Mailing Address - Fax:
Practice Address - Street 1:884 W PARK AVE
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-2273
Practice Address - Country:US
Practice Address - Phone:360-385-0321
Practice Address - Fax:360-385-3944
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1443-C1041C0700X
WALW611620741041C0700X
WASC60910701101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor