1255635587 NPI number — MELANIE MARIE BOYCE LPC

Table of content: MELANIE MARIE BOYCE LPC (NPI 1255635587)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255635587 NPI number — MELANIE MARIE BOYCE LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOYCE
Provider First Name:
MELANIE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PAUL-COOK
Provider Other First Name:
MELANIE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1255635587
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
631 OGDEN AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEARFIELD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16830
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-465-5576
Provider Business Mailing Address Fax Number:
724-465-6379

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 1/2 EAST LOCUST STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEARFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-577-5634
Provider Business Practice Location Address Fax Number:
814-371-0120
Provider Enumeration Date:
12/30/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)