Provider Demographics
NPI:1134460041
Name:CARTER BOYD, DANA (LPC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:CARTER BOYD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6243 W INTERSTATE 10
Mailing Address - Street 2:STE 1050
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-2086
Mailing Address - Country:US
Mailing Address - Phone:210-293-0883
Mailing Address - Fax:210-293-0885
Practice Address - Street 1:6243 W INTERSTATE 10
Practice Address - Street 2:STE 1050
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-2086
Practice Address - Country:US
Practice Address - Phone:210-293-0883
Practice Address - Fax:210-293-0885
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional