Damion L Boyd Sr., LPC – Professional Counselor

Key facts

NPI: 1255810388
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: C2304928 (OH)
Practice address: 123 S Washington St
Van Wert, OH 45891-1707
Phone: (419) 771-1050
Fax: (419) 771-1051
NPI assigned: Aug 9, 2018
Sex: Male
Sole proprietor: No

Organizations & group practices 2

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.

Angel Intervention Services LLC Comprehensive Outpatient Rehabilitation Facility (CORF) · Van Wert, OH · NPI 1801311121

NPD
Belinda J. Torres, PH.D. & Associates, LLC Clinical Psychologist · Willoughby Hills, OH · NPI 1255491908

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
C2304928	OH	MD	Professional Counselor

Practice roles

Organization	Specialty	Status	New patients
Angel Intervention Services LLC		Current since Jun 25, 2023	Accepting new patients
Belinda J. Torres, PH.D. & Associates, LLC		Past since Dec 11, 2021	Accepting new patients

Locations

123 S Washington St
Van Wert, OH 45891
Phone (419) 771-1050

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Case Manager/Care Coordinator	171M00000X
Professional Counselor	101YP2500X	C2304928	OH	Yes

Addresses

Primary practice location

123 S Washington St
Van Wert, OH 45891-1707

Mailing address

123 S Washington St
Van Wert, OH 45891-1707
Phone (419) 771-1050

Other practice location 1

35040 Chardon Rd Ste 115
Willoughby Hills, OH 44094-9004
Phone (440) 358-1159

Other identifiers

Identifier	Type	State	Issuer
0462828	Medicaid	OH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 8, 2023.

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1255810388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S WASHINGTON ST",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911707",
            "telephone_number": "419-771-1050",
            "fax_number": "419-771-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S WASHINGTON ST",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911707",
            "telephone_number": "419-771-1050",
            "fax_number": "419-771-1051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35040 Chardon Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Willoughby Hills",
            "state": "OH",
            "postal_code": "440949004",
            "country_code": "US",
            "telephone_number": "440-358-1159",
            "fax_number": "440-445-0656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "DAMION",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-09",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C2304928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0462828",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Wert, OH

All providers in Van Wert, OH · Professional Counselor in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.