Provider Demographics
NPI:1770676520
Name:BOYD, DEBBI J (MC, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:DEBBI
Middle Name:J
Last Name:BOYD
Suffix:
Gender:F
Credentials:MC, NCC, LPC
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 912
Mailing Address - Street 2:
Mailing Address - City:VINITA
Mailing Address - State:OK
Mailing Address - Zip Code:74301-0912
Mailing Address - Country:US
Mailing Address - Phone:918-256-7518
Mailing Address - Fax:918-256-6771
Practice Address - Street 1:1520 NORTH INDUSTRIAL ROAD
Practice Address - Street 2:
Practice Address - City:VINITA
Practice Address - State:OK
Practice Address - Zip Code:74301-0912
Practice Address - Country:US
Practice Address - Phone:918-256-7518
Practice Address - Fax:918-256-6771
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPC-4761101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor