Provider Demographics
NPI:1376972455
Name:BOYD, SHEENA LOUISE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:LOUISE
Last Name:BOYD
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 ACOMA LN W
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-2451
Mailing Address - Country:US
Mailing Address - Phone:714-469-6575
Mailing Address - Fax:
Practice Address - Street 1:1520 ACOMA LN W
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-2451
Practice Address - Country:US
Practice Address - Phone:714-469-6575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF74041106H00000X
CA109664106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist