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General NPI Number Information
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NPI Number | 1508747858
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Entity Type | Organization
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Legal Business Name | SAM BOYD COUNSELING PLLC
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 53 W JACKSON BLVD STE 1028
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City | CHICAGO
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State | IL
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Zip | 60604-3648
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Country | US
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Telephone | 423-202-6769
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Fax |
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Provider Business Mailing Address
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Address Line | 6312 N PAULINA ST APT 3A
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City | CHICAGO
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State | IL
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Zip | 60660-1148
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Country | US
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Telephone | 423-202-6769
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | SAMUEL DAVID BOYD
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Credential | LPC
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Telephone | 423-202-6769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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