MEDICARE: MRS. ALYSSA SHAWN BOYER L.C.P.C.

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	101Y00000X	Counselor	LCPC 776	KS
2	101YM0800X	Mental Health Counselor	LCPC 776	KS
3	101YP2500X	Professional Counselor	LCPC 776	KS

General Provider Information

NPI Number	:	1841330685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALYSSA SHAWN BOYER L.C.P.C.

Provider Business Mailing Address
First Line	:	4635 N COBBLESTONE ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67204-2300
Country	:	US
Telephone Number	:	316-644-6519
Fax Number	:

Provider Business Practice Location Address
First Line	:	4635 N COBBLESTONE ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67204-2300
Country	:	US
Telephone Number	:	316-644-6519
Fax Number	:

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	07/18/2025

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