National Provider Identifier
Samuel Blackman Boyles, LCSW
Samuel Blackman Boyles, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Ithaca, NY and a listed phone number of (607) 273-7494.
Profile Overview
- NPI
- 1720753262
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- August 16, 2021
- Last Updated
- August 27, 2025
Practice Location
- 127 W State St
- Ithaca, NY 14850-5474
Phone: (607) 273-7494
Mailing Address
- 401 Linn St
- Ithaca, NY 14850-3738
Specialties
- Clinical Social Worker (1041C0700X)
- Social Worker (104100000X)
Full Record
- NPI
- 1720753262
- Entity Type
- Individual
- Last Name
- Boyles
- First Name
- Samuel
- Middle Name
- Blackman
- Credential
- LCSW
- Mailing Street Address
- 401 Linn St
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-3738
- Mailing Country
- US
- Practice Street Address
- 127 W State St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5474
- Practice Country
- US
- Practice Phone
- (607) 273-7494
- Enumeration Date
- August 16, 2021
- Last Updated
- August 27, 2025
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- August 27, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X), Social Worker (104100000X)