Healthcare Provider Details

I. General information

NPI: 1164772232
Provider Name (Legal Business Name): ANNMARIE BOYD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 CARLISLE BLVD NE STE 207
ALBUQUERQUE NM
87107-4849
US

IV. Provider business mailing address

4925 S BROADWAY AVE # 1156
WICHITA KS
67216-3716
US

V. Phone/Fax

Practice location:
  • Phone: 505-264-4032
  • Fax:
Mailing address:
  • Phone: 505-264-4032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-08014
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: