Bertina Hansen Boyd, L.C.S.W.-C.

Individual provider Active NPI Clinical Social Worker · Dunkirk, MD

NPI 1790728194 · NPPES record last updated Jul 20, 2010

Key facts

NPI
1790728194
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
09190 (MD)
Practice address
3175 W Ward Rd
200
Dunkirk, MD 20754-3024
Phone
(410) 286-0664
Fax
(410) 286-2834
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
9190MDMDDentist
09190MDMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 09190 MD Yes

Addresses

Primary practice location

3175 W Ward Rd
200
Dunkirk, MD 20754-3024

Mailing address

3175 W Ward Rd
200
Dunkirk, MD 20754-3024
Phone (410) 286-0664

Other identifiers

IdentifierTypeStateIssuer
403192000MedicaidMD

Other providers in Dunkirk, MD

All providers in Dunkirk, MD · Clinical Social Worker in Maryland

Sources for this page

Verify at the official NPI Registry.