Individual provider Active NPI

Lakisha Patrice Boykin, LPCA

  • Professional Counselor
  • Winston Salem, NC
National Provider Identifier
1063961084
Registry record updated Aug 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A11337 Issued in NC
Practice address
725 N Highland Ave
Unit 100
Winston Salem, NC 27101-4180
Phone
(336) 607-8523
Fax
(336) 773-0916
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A11337 NC Primary

Addresses

Primary practice location

725 N Highland Ave
Unit 100
Winston Salem, NC 27101-4180

Mailing address

284 Executive Park Dr
Suite 100
Concord, NC 28025-1833
Phone (704) 939-1100

Other identifiers 2

IdentifierTypeStateIssuer
1063961084MedicaidNC
19PC2OtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A11337NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Servcies Inc Professional Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502755200000",
    "number": "1063961084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR",
            "address_2": "SUITE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N HIGHLAND AVE",
            "address_2": "UNIT 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271014180",
            "telephone_number": "336-607-8523",
            "fax_number": "336-773-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYKIN",
        "first_name": "LAKISHA",
        "middle_name": "PATRICE",
        "name_prefix": "Mrs.",
        "credential": "LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2017-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A11337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063961084",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "19PC2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.