Healthcare Provider Details

I. General information

NPI: 1275498610
Provider Name (Legal Business Name): ROBERT BOYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 CLIFTY ST
SOMERSET KY
42503-1715
US

IV. Provider business mailing address

344 PRICE BURNETT RD
SOMERSET KY
42503-5500
US

V. Phone/Fax

Practice location:
  • Phone: 877-848-9810
  • Fax:
Mailing address:
  • Phone: 859-536-1701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: