Healthcare Provider Details

I. General information

NPI: 1821523242
Provider Name (Legal Business Name): JEREMY BOYCE MASTER OF ARTS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2017
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 RIVERSIDE DR
MONROE LA
71201-6211
US

IV. Provider business mailing address

179 HAMILTON RD
DOWNSVILLE LA
71234-4203
US

V. Phone/Fax

Practice location:
  • Phone: 318-398-0945
  • Fax:
Mailing address:
  • Phone: 318-235-3383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7256
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: