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Provider Information for 1366698722


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Mr. JOSEPH D. BOIVIN LPC/LADC/CHES


Sex: Male

NPI: 1366698722
Last Updated: 2024-08-28
Certification Date: 2024-08-28

Details

NameValue
NPI1366698722
Enumeration Date2008-08-16
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 995 DAY HILL RD
WINDSOR, CT 06095-1722
United States

Phone: 860-731-5522 | Fax:860-731-5536
 
Primary Practice Address 16 MAIN ST
ELLINGTON, CT 06029-3360
United States

Phone: 860-871-5402 | Fax:860-871-5413
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalCT001186
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)CT000565