Provider Demographics
NPI:1356011985
Name:BOYD, RICHARD (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:BOYD
Suffix:
Gender:M
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2671 PEBBLE DAWN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4167
Mailing Address - Country:US
Mailing Address - Phone:210-233-8063
Mailing Address - Fax:
Practice Address - Street 1:2935 THOUSAND OAKS DR STE 6-231
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3563
Practice Address - Country:US
Practice Address - Phone:210-233-8063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86444101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional