Mykl Boyd-Raska

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Sioux City, IA

NPI 1245978006 · NPPES record last updated May 23, 2022

Key facts

NPI
1245978006
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
1115 5TH St
Sioux City, IA 51101-1905
Phone
(712) 255-0890
NPI assigned
May 23, 2022
Sex
Male
Sole proprietor
No

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Wellness Associates, Inc. Past
since May 29, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

1115 5TH St
Sioux City, IA 51101-1905

Mailing address

2801 Jennings St
Sioux City, IA 51104-3626
Phone (712) 899-8362

Other providers in Sioux City, IA

All providers in Sioux City, IA · Addiction (Substance Use Disorder) Counselor in Iowa

Sources for this page

Verify at the official NPI Registry.