Provider Demographics
NPI:1598061152
Name:BOYD, RUTH C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:C
Last Name:BOYD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15-2662 PAHOA VILLAGE RD # 306
Mailing Address - Street 2:#8926
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-7730
Mailing Address - Country:US
Mailing Address - Phone:808-938-8308
Mailing Address - Fax:866-402-4540
Practice Address - Street 1:15-1791 14TH AVE
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749-0000
Practice Address - Country:US
Practice Address - Phone:808-938-8830
Practice Address - Fax:866-402-4540
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2012-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI32371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical