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General NPI Number Information
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NPI Number | 1780279497
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Entity Type | Individual
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Provider Name | REESE BOYD LPC
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Gender | Male
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 23412 COMMERCE PARK
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City | BEACHWOOD
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State | OH
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Zip | 44122-5813
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Country | US
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Telephone | 216-400-6640
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Fax | 216-250-7016
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Provider Business Mailing Address
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Address Line | 761 PROVIDENCE CT APT 302
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City | STREETSBORO
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State | OH
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Zip | 44241-4036
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Country | US
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Telephone | 740-296-1889
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | C.2002868-TRNE
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2204603
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License Number State | OH
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