Provider Demographics
NPI:1144351784
Name:BOYER, PAULA LYN (MSW)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:LYN
Last Name:BOYER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 ROLLING RIDGE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7641
Mailing Address - Country:US
Mailing Address - Phone:814-867-0670
Mailing Address - Fax:814-867-7616
Practice Address - Street 1:320 ROLLING RIDGE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7641
Practice Address - Country:US
Practice Address - Phone:814-867-0670
Practice Address - Fax:814-867-7616
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACWO149131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1825665OtherHIGHMARK FEDERAL
PA2227772OtherCIGNA BEHAVIORAL HEALTH
PA276957OtherCOMPSYCH
PAMHS548772OtherVALUE OPTIONS
PA1825665OtherHIGHMARK FEDERAL