MEDICARE: MACKENZIE LAUREN BOYLES LCMHCA

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	101YP2500X	Professional Counselor	A22417	NC

General Provider Information

NPI Number	:	1679422802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE LAUREN BOYLES LCMHCA

Provider Business Mailing Address
First Line	:	115 MILLSEAT DR
Second Line	:
City	:	ARARAT
State	:	NC
Zip	:	27007-8170
Country	:	US
Telephone Number	:	336-710-8565
Fax Number	:

Provider Business Practice Location Address
First Line	:	714 CAROLINA AVE STE A
Second Line	:
City	:	YADKINVILLE
State	:	NC
Zip	:	27055-7793
Country	:	US
Telephone Number	:	336-818-0733
Fax Number	:

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

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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Directions to “ MACKENZIE LAUREN BOYLES LCMHCA” Practice Location

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