Susan Margaret Boyan, MFT

Individual provider Active NPI Marriage & Family Therapist · Brookhaven, GA

NPI 1124416516 · NPPES record last updated Jan 7, 2015

Key facts

NPI
1124416516
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
000369 (GA)
Practice address
1936 N Druid Hills Rd NE Ste a
Brookhaven, GA 30319-4131
Phone
(404) 273-3370
Fax
(404) 982-0006
NPI assigned
Jan 7, 2015
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
000369GAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boyan LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 000369 GA Yes

Addresses

Primary practice location

1936 N Druid Hills Rd NE Ste a
Brookhaven, GA 30319-4131

Mailing address

1936 N Druid Hills Rd NE Ste a
Brookhaven, GA 30319-4131
Phone (404) 273-3370

Other providers in Brookhaven, GA

All providers in Brookhaven, GA · Marriage & Family Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.