Individual provider Active NPI

Tushonda Fleeton Boyd, LCSW

  • Clinical Social Worker
  • Biloxi, MS
National Provider Identifier
1700966850
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C5605 Issued in MS
Practice address
232 Eisenhower Dr Ste B
Biloxi, MS 39531-3601
Phone
(601) 688-4118
Fax
(228) 206-1064
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C5605 MS Primary

Addresses

Primary practice location

232 Eisenhower Dr Ste B
Biloxi, MS 39531-3601

Mailing address

PO Box 6771
Diberville, MS 39540-6771
Phone (601) 688-4118

Other practice location 1

400 Veterans Ave
Biloxi, MS 39531-2410
Phone (228) 523-5176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230727000243 MS Practitioner - Clinical Social Worker 7416315619 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C5605MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Made Counseling Services LLC Clinical CurrentSince Jun 7, 2023 Accepting new patients
PRX Health Institute, LLC PastSince Jun 7, 2023 Accepting new patients

Locations

232 Eisenhower Dr
#B
Biloxi, MS 39531
Phone (228) 207-5191

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1700966850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6771",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395406771",
            "telephone_number": "601-688-4118",
            "fax_number": "228-220-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 EISENHOWER DR STE B",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395313601",
            "telephone_number": "601-688-4118",
            "fax_number": "228-206-1064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Veterans Ave",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "395312410",
            "country_code": "US",
            "telephone_number": "228-523-5176",
            "fax_number": "228-523-5257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "TUSHONDA",
        "middle_name": "FLEETON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C5605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.