Healthcare Provider Details

I. General information

NPI: 1396621587
Provider Name (Legal Business Name): LEAH BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 E BARTHMAN AVE
COLUMBUS OH
43207-1921
US

IV. Provider business mailing address

7432 BASIL WESTERN RD NW
CANAL WINCHESTER OH
43110-9207
US

V. Phone/Fax

Practice location:
  • Phone: 380-799-6061
  • Fax: 614-396-9300
Mailing address:
  • Phone: 951-323-2082
  • Fax: 614-396-9300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: