Provider Demographics
NPI:1578108197
Name:BOYKIN, SUSAN ELIZABETH (ACSW, LISW-CP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:BOYKIN
Suffix:
Gender:F
Credentials:ACSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:IA
Mailing Address - Zip Code:50250-7703
Mailing Address - Country:US
Mailing Address - Phone:515-523-8127
Mailing Address - Fax:
Practice Address - Street 1:5 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365-1610
Practice Address - Country:US
Practice Address - Phone:843-729-8341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical