Provider Demographics
NPI:1811588767
Name:BOYD, BRIANNE ROCHELLE (LPC)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:ROCHELLE
Last Name:BOYD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 WHITE OAK CIR APT 104
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97351-8611
Mailing Address - Country:US
Mailing Address - Phone:503-602-5100
Mailing Address - Fax:
Practice Address - Street 1:805 LIBERTY ST NE STE 2
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2463
Practice Address - Country:US
Practice Address - Phone:503-589-3112
Practice Address - Fax:503-589-3179
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC8536101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health