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Provider Information for 1427591221


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Mr. JOSHUA M BOYCE LCSW


Sex: Male

NPI: 1427591221
Last Updated: 2024-08-09
Certification Date: 2024-08-09

Details

NameValue
NPI1427591221
Enumeration Date2016-11-28
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 2516 CRYSTAL CT APT 101
WOODRIDGE, IL 60517-4034
United States

Phone: 765-993-1483 | Fax:765-993-1483
 
Primary Practice Address 2516 CRYSTAL CT APT 101
WOODRIDGE, IL 60517-4034
United States

Phone: 765-993-1483 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 1041C0700X - Social Worker - ClinicalIL149022142
No 1041C0700X - Social Worker - ClinicalCOCSW.09927865
No 1041C0700X - Social Worker - ClinicalTN7982
Yes 1041C0700X - Social Worker - ClinicalMALICSW126097