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NPI Code Detail

MEDICARE: KASSINDRA BOYDEN LMSW

MEDICARE: KASSINDRA BOYDEN LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerL258837MI
21041C0700XClinical Social Worker6801108760MI

General Provider Information

NPI Number : 1225436819
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASSINDRA BOYDEN LMSW
Provider Business Mailing Address
First Line : 17321 TELEGRAPH RD
Second Line :
City : DETROIT
State : MI
Zip : 48219-3132
Country : US
Telephone Number : 313-255-0900
Fax Number :
Provider Business Practice Location Address
First Line : 19750 BURT RD
Second Line :
City : DETROIT
State : MI
Zip : 48219-2078
Country : US
Telephone Number : 313-977-9550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2014
Last Update Date : 09/09/2021

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Directions to “ KASSINDRA BOYDEN LMSW” Practice Location

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