Provider Demographics
NPI:1548859838
Name:BOYLES, ELIZABETH ANN (MSW; LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:BOYLES
Suffix:
Gender:F
Credentials:MSW; LCSW
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:BOWLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW; LCSW
Mailing Address - Street 1:407 W COVELL RD UNIT 30903
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-2242
Mailing Address - Country:US
Mailing Address - Phone:405-531-0726
Mailing Address - Fax:
Practice Address - Street 1:401 E MEMORIAL RD STE 500
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-2287
Practice Address - Country:US
Practice Address - Phone:405-531-0726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK86241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical