Chanda Elaine Boyden-Deidrick, MSW, LCSW, LISW

Individual provider Active NPI Clinical Social Worker · Pittsboro, IN

NPI 1629774286 · NPPES record last updated Apr 14, 2023

Key facts

NPI
1629774286
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
34007615A (IN)
Practice address
1731 E County Road 600 N
Pittsboro, IN 46167-9011
Phone
(317) 938-8517
NPI assigned
Feb 6, 2023
Sex
Female
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

State licenses

LicenseStateTypeSpecialty
34007615AINMDClinical Social Worker
I.2203741OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Path Therapy P.C. Clinical Current
since Apr 16, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.2203741 OH
Clinical Social Worker 1041C0700X 34007615A IN Yes

Addresses

Primary practice location

1731 E County Road 600 N
Pittsboro, IN 46167-9011

Mailing address

1731 E County Road 600 N
Pittsboro, IN 46167-9011
Phone (317) 938-8517

Other providers in Pittsboro, IN

All providers in Pittsboro, IN · Clinical Social Worker in Indiana

Sources for this page

Verify at the official NPI Registry.