Provider Demographics
NPI:1659987048
Name:BOYD, KELSEY MCCOY (LCDC)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:MCCOY
Last Name:BOYD
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11503 PARSONS RD
Mailing Address - Street 2:
Mailing Address - City:MANOR
Mailing Address - State:TX
Mailing Address - Zip Code:78653-5220
Mailing Address - Country:US
Mailing Address - Phone:512-567-6103
Mailing Address - Fax:
Practice Address - Street 1:11502 PARSONS RD
Practice Address - Street 2:
Practice Address - City:MANOR
Practice Address - State:TX
Practice Address - Zip Code:78653-5220
Practice Address - Country:US
Practice Address - Phone:512-273-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15418101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)