Provider Demographics
NPI:1467056648
Name:BOYD, JOY (MS, LMHC, CSAYC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:MS, LMHC, CSAYC
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 532295
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46253-2295
Mailing Address - Country:US
Mailing Address - Phone:317-210-3432
Mailing Address - Fax:
Practice Address - Street 1:3500 DEPAUW BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-5931
Practice Address - Country:US
Practice Address - Phone:317-210-3432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003519A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300056945Medicaid