Active NPI
Samuel Henry Boyd Jr., LSW, LICDC-CS
- Addiction (Substance Use Disorder) Counselor
- Columbus, OH
National Provider Identifier
1417480195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 965723
- Practice address
- 2050 Kenny Rd
Suite 3300
Columbus, OH 43221-3502 - Phone
- (614) 685-2730
- Fax
- (614) 293-9502
- NPI assigned
- Apr 10, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 965723 | OH | Primary |
| Social Worker | 104100000X | S-0015831 | OH |
Addresses
Primary practice location
2050 Kenny Rd
Suite 3300
Columbus, OH 43221-3502
Mailing address
2050 Kenny Rd.
Suite 3300
Columbus, OH 43221
Phone (614) 685-2730
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YA0400X | Medicaid | OH | |
| 101Y60000X | Medicaid | OH | |
| 104100000X | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 965723 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| S-0015831 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491782400000",
"number": "1417480195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050 KENNY RD.",
"address_2": "SUITE 3300",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43221",
"telephone_number": "614-685-2730",
"fax_number": "614-293-9502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 KENNY RD",
"address_2": "SUITE 3300",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432213502",
"telephone_number": "614-685-2730",
"fax_number": "614-293-9502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "SAMUEL",
"middle_name": "HENRY",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LSW, LICDC-CS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-10",
"last_updated": "2017-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "965723",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S-0015831",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101YA0400X",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101Y60000X",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104100000X",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.