MEDICARE: MR. RONALD L BOYCE LCSW LSAC

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	104100000X	Social Worker	3338213501	UT
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1962468330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD L BOYCE LCSW LSAC

Provider Business Mailing Address
First Line	:	2210 N ELDORADO AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-6418
Country	:	US
Telephone Number	:	541-883-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 N ELDORADO AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-6418
Country	:	US
Telephone Number	:	541-883-1010
Fax Number	:

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	08/11/2023

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