Healthcare Provider Details

I. General information

NPI: 1912680141
Provider Name (Legal Business Name): CATHERINE BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 BROADWAY
BETHLEHEM PA
18015-3904
US

IV. Provider business mailing address

1620 BROADWAY
BETHLEHEM PA
18015-3904
US

V. Phone/Fax

Practice location:
  • Phone: 610-799-8600
  • Fax:
Mailing address:
  • Phone: 610-799-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: