Provider Demographics
NPI:1245773647
Name:BOYD, KATRINA (LCSW)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 CRESCENDO CT
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-8027
Mailing Address - Country:US
Mailing Address - Phone:812-480-7711
Mailing Address - Fax:
Practice Address - Street 1:2750 N BURKHARDT RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-1685
Practice Address - Country:US
Practice Address - Phone:812-773-8737
Practice Address - Fax:812-901-6168
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006909A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN34006909AOtherLICENSE