Charles Russell Boyd Jr., LPC

Individual provider Active NPI Mental Health Counselor · Olathe, KS

NPI 1427262146 · NPPES record last updated Jun 9, 2008

Key facts

NPI
1427262146
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
LPC 1855 (KS)
Practice address
21350 W 153Rd St
Olathe, KS 66061-5413
Phone
(913) 322-2400
Fax
(913) 621-5730
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

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
LPC 1855KSMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC 1855 KS Yes

Addresses

Primary practice location

21350 W 153Rd St
Olathe, KS 66061-5413

Mailing address

18788 Harveyville Rd
Harveyville, KS 66431-9220
Phone (785) 828-3411

Other providers in Olathe, KS

All providers in Olathe, KS · Mental Health Counselor in Kansas

Sources for this page

Verify at the official NPI Registry.