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NPI Code Detail

MEDICARE: DANIELLE BOYKIN

MEDICARE: DANIELLE BOYKIN
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
1101YA0400XAddiction (Substance Use Disorder) Counselor99136515AIN
2171M00000XCase Manager/Care Coordinator
3101YM0800XMental Health Counselor99129680AIN

General Provider Information

NPI Number : 1992271407
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE BOYKIN
Provider Business Mailing Address
First Line : 1313 W WASHINGTON CENTER RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-4142
Country : US
Telephone Number : 260-424-4908
Fax Number : 260-264-4146
Provider Business Practice Location Address
First Line : 1313 W WASHINGTON CENTER RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-4142
Country : US
Telephone Number : 260-424-4908
Fax Number : 260-264-4146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2018
Last Update Date : 05/20/2026

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Directions to “ DANIELLE BOYKIN ” Practice Location

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