Provider Demographics
NPI:1326259607
Name:BOYD, STEPHEN JOSEPH (PHD,LPCC,LMFT,NCP)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:BOYD
Suffix:
Gender:M
Credentials:PHD,LPCC,LMFT,NCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 54425
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45254-0425
Mailing Address - Country:US
Mailing Address - Phone:513-231-9863
Mailing Address - Fax:513-231-8227
Practice Address - Street 1:4030 MOUNT CARMEL TOBASCO RD
Practice Address - Street 2:SUITE 326
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3400
Practice Address - Country:US
Practice Address - Phone:513-528-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2014-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY#0434106H00000X
OK#1173103T00000X
OH#0001744101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist