Christopher D. Boyle

Individual provider Active NPI Clinical Psychologist · Goldsboro, NC

NPI 1780763003 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1780763003
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
1612 (NC)
Practice address
2400 Wayne Memorial Dr
Suite E
Goldsboro, NC 27534-1789
Phone
(919) 736-7900
Fax
(919) 736-2424
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1612NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Waynesborough Psychological Services Past Accepting new patients
Eastern Nephrology Associates PLLC Past
since Apr 17, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1612 NC Yes

Addresses

Primary practice location

2400 Wayne Memorial Dr
Suite E
Goldsboro, NC 27534-1789

Mailing address

2400 Wayne Memorial Dr
Suite E
Goldsboro, NC 27534-1789
Phone (919) 736-7900

Other identifiers

IdentifierTypeStateIssuer
6107075MedicaidNC

Other providers in Goldsboro, NC

All providers in Goldsboro, NC · Clinical Psychologist in North Carolina

Sources for this page

Verify at the official NPI Registry.