Healthcare Provider Details

I. General information

NPI: 1326259607
Provider Name (Legal Business Name): STEPHEN JOSEPH BOYD PHD,LPCC,LMFT,NCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 04/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 MOUNT CARMEL TOBASCO RD SUITE 326
CINCINNATI OH
45255-3400
US

IV. Provider business mailing address

PO BOX 54425
CINCINNATI OH
45254-0425
US

V. Phone/Fax

Practice location:
  • Phone: 513-528-3838
  • Fax:
Mailing address:
  • Phone: 513-231-9863
  • Fax: 513-231-8227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number#0001744
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number#1173
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number#0434
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: