Provider Demographics
NPI:1699288654
Name:BOYER, CAROLYN (LCPC)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:BOYER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 MOCHEL DR STE 307
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5078
Mailing Address - Country:US
Mailing Address - Phone:630-963-5390
Mailing Address - Fax:
Practice Address - Street 1:5151 MOCHEL DR STE 307
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5078
Practice Address - Country:US
Practice Address - Phone:630-963-5390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.013407101YP2500X
IL180.013126101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional