MEDICARE: RICK BOYES LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPC-64	ID

General Provider Information

NPI Number	:	1538478862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICK BOYES LPC

Provider Business Mailing Address
First Line	:	4477 W EMERALD ST
Second Line	:	SUITE C-110
City	:	BOISE
State	:	ID
Zip	:	83706-2000
Country	:	US
Telephone Number	:	208-344-3070
Fax Number	:

Provider Business Practice Location Address
First Line	:	4477 W EMERALD ST
Second Line	:	SUITE C-110
City	:	BOISE
State	:	ID
Zip	:	83706-2000
Country	:	US
Telephone Number	:	208-344-3070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2010
Last Update Date	:	10/05/2010

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Directions to “ RICK BOYES LPC” Practice Location

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