Healthcare Provider Details

I. General information

NPI: 1942031315
Provider Name (Legal Business Name): ANGEL LYNN BOYD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGEL LYNN WHITED

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 E MAIN ST
SPINDALE NC
28160-1938
US

IV. Provider business mailing address

149 KILMER DR
FOREST CITY NC
28043-3169
US

V. Phone/Fax

Practice location:
  • Phone: 704-284-9588
  • Fax:
Mailing address:
  • Phone: 704-284-9588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017197
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC018726
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: