Healthcare Provider Details

I. General information

NPI: 1821911751
Provider Name (Legal Business Name): ESHA BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 WAREHAM RD
MARION MA
02738-1134
US

IV. Provider business mailing address

385 WAREHAM RD
MARION MA
02738-1134
US

V. Phone/Fax

Practice location:
  • Phone: 414-975-8425
  • Fax: 313-279-0413
Mailing address:
  • Phone: 414-975-8425
  • Fax: 313-279-0413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW2141191
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: