Provider Demographics
NPI:1275104168
Name:BOYD, MEGHAN NICHOLE (LMSW)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:NICHOLE
Last Name:BOYD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:NICHOLE
Other - Last Name:CLOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 BLUE WATER CT UNIT 304
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-2372
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2009 SAINT STEPHENS WOODS DR
Practice Address - Street 2:
Practice Address - City:CROWNSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21032-2200
Practice Address - Country:US
Practice Address - Phone:240-673-6107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24258104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker