Provider Demographics
NPI:1922257336
Name:BOYD, STEVEN WALTER (MDIV, LADC, MAC,)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:WALTER
Last Name:BOYD
Suffix:
Gender:M
Credentials:MDIV, LADC, MAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4708 PARKPOINT CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-7211
Mailing Address - Country:US
Mailing Address - Phone:775-857-2678
Mailing Address - Fax:
Practice Address - Street 1:1201 CORPORATE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-7101
Practice Address - Country:US
Practice Address - Phone:775-857-2999
Practice Address - Fax:775-857-2998
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01124-L101YA0400X
NVNO NUMBER101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral