Provider Demographics
NPI:1750955845
Name:BOYD, SHERNAY JANIELLE (LAC)
Entity type:Individual
Prefix:
First Name:SHERNAY
Middle Name:JANIELLE
Last Name:BOYD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7126 HAMILTON WAY
Mailing Address - Street 2:
Mailing Address - City:EASTAMPTON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1681
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7126 HAMILTON WAY
Practice Address - Street 2:
Practice Address - City:EASTAMPTON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08060-1681
Practice Address - Country:US
Practice Address - Phone:609-300-4392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00548600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health