Provider Demographics
NPI:1811746548
Name:BOYD-BOLME, AMY M (LMSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:BOYD-BOLME
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:M
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:217 W ROSSER AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3755
Mailing Address - Country:US
Mailing Address - Phone:701-255-6909
Mailing Address - Fax:701-255-3922
Practice Address - Street 1:217 W ROSSER AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3755
Practice Address - Country:US
Practice Address - Phone:701-255-6909
Practice Address - Fax:701-255-3922
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4393104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker