Provider Demographics
NPI:1457605743
Name:BOYD, CESSEL JEWON (MA, LPCA)
Entity Type:Individual
Prefix:MS
First Name:CESSEL
Middle Name:JEWON
Last Name:BOYD
Suffix:
Gender:F
Credentials:MA, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 BRIDGET WAY
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522-9706
Mailing Address - Country:US
Mailing Address - Phone:919-698-9972
Mailing Address - Fax:
Practice Address - Street 1:204 BRIDGET WAY
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-9706
Practice Address - Country:US
Practice Address - Phone:919-698-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9324101YM0800X
NC3117101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)