Provider Demographics
NPI:1912618935
Name:KERRIE BOYDMAN, LCSW LCC
Entity Type:Organization
Organization Name:KERRIE BOYDMAN, LCSW LCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-444-5062
Mailing Address - Street 1:9400 MCKNIGHT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6007
Mailing Address - Country:US
Mailing Address - Phone:412-444-5062
Mailing Address - Fax:
Practice Address - Street 1:9400 MCKNIGHT RD STE 201
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6007
Practice Address - Country:US
Practice Address - Phone:412-444-5062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty