Healthcare Provider Details
I. General information
NPI: 1861175770
Provider Name (Legal Business Name): MICHAEL BOYLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/08/2023
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6801 JEFFERSON ST NE
ALBUQUERQUE NM
87109-4379
US
IV. Provider business mailing address
87 YORKTOWN ST
SOMERVILLE MA
02144-2424
US
V. Phone/Fax
- Phone: 617-237-0321
- Fax: 617-302-8829
- Phone: 617-237-0321
- Fax: 617-302-8829
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
BOYLE
Title or Position: OWNER
Credential: LMFT
Phone: 617-237-0321