Provider Demographics
NPI:1417545583
Name:BOYD, NINA (LPC)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07062-1313
Mailing Address - Country:US
Mailing Address - Phone:908-917-1124
Mailing Address - Fax:
Practice Address - Street 1:672 ROUTE 202/206 STE 106
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-1747
Practice Address - Country:US
Practice Address - Phone:908-917-1124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00739500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional