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General NPI Number Information
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NPI Number | 1689770422
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Entity Type | Individual
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Provider Name | BOYCE FIELDS JR. LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7950 MARTIN LOOP 7950 MARTIN LOOP
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City | FORT BENNING
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State | GA
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Zip | 31905-5647
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Country | US
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Telephone | 706-544-4760
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Fax |
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Provider Business Mailing Address
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Address Line | 4528 ESTHER CT
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City | COLUMBUS
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State | GA
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Zip | 31909-7311
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Country | US
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Telephone | 706-563-7256
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1564
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License Number State | GA
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