Provider Demographics
NPI:1952824179
Name:BOYKIN, KERRI ANN (LCSWA)
Entity Type:Individual
Prefix:
First Name:KERRI ANN
Middle Name:
Last Name:BOYKIN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 HILLBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-9715
Mailing Address - Country:US
Mailing Address - Phone:991-062-4227
Mailing Address - Fax:
Practice Address - Street 1:920 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5300
Practice Address - Country:US
Practice Address - Phone:910-493-3555
Practice Address - Fax:910-493-3520
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0118081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical