Provider Demographics
NPI:1013263359
Name:BOYKIN, DEDRIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:DEDRIE
Middle Name:
Last Name:BOYKIN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9208 REDBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1768
Mailing Address - Country:US
Mailing Address - Phone:240-350-9281
Mailing Address - Fax:202-877-0343
Practice Address - Street 1:9208 REDBRIDGE CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1768
Practice Address - Country:US
Practice Address - Phone:240-350-9281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500794501041C0700X
MD175121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical