Provider Demographics
NPI:1033243159
Name:BOYD, DENISE (BS)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:BIVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:1010 E ADAMS ST
Mailing Address - Street 2:SUITE 235
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-1902
Mailing Address - Country:US
Mailing Address - Phone:904-738-8579
Mailing Address - Fax:904-619-7835
Practice Address - Street 1:1010 E ADAMS ST
Practice Address - Street 2:SUITE 235
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-1902
Practice Address - Country:US
Practice Address - Phone:904-738-8579
Practice Address - Fax:904-619-7835
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH5303OtherCOMM. BEHAVIORAL HEALTH