MEDICARE: ELENA BOYLE COUNSELING SERVICES

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1871027110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELENA BOYLE COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	538 FRANK APPLEGATE RD
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-4221
Country	:	US
Telephone Number	:	908-812-6960
Fax Number	:

Provider Business Practice Location Address
First Line	:	538 FRANK APPLEGATE RD
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-4221
Country	:	US
Telephone Number	:	908-812-6960
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ELENA BOYLE
Credential	:	M.A., LCADC, LPC
Telephone Number	:	908-812-6960

Provider Enumeration Date	:	04/13/2017
Last Update Date	:	04/13/2017

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