Provider Demographics
NPI:1477730216
Name:BROWN-BOYD, ASHLEY MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MICHELLE
Last Name:BROWN-BOYD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ASHELY
Other - Middle Name:MICHELLE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1326
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75671-1326
Mailing Address - Country:US
Mailing Address - Phone:903-927-3782
Mailing Address - Fax:903-927-1764
Practice Address - Street 1:1400 COLLEGE DR. STE 204
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503
Practice Address - Country:US
Practice Address - Phone:903-791-1110
Practice Address - Fax:903-791-9353
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX509271041C0700X
AR2477-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX50927OtherTX LICENSE