Provider Demographics
NPI:1841482122
Name:BOYD, LAURA BOISVERT (MED, LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:BOISVERT
Last Name:BOYD
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6009 EPPING FOREST DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-4075
Mailing Address - Country:US
Mailing Address - Phone:919-786-0391
Mailing Address - Fax:
Practice Address - Street 1:9933 OLDE TOWNE SQUARE, HWY 70W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520
Practice Address - Country:US
Practice Address - Phone:919-359-9070
Practice Address - Fax:919-359-9071
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5069101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional