Individual provider Active NPI

Tamara R Boyd

  • Counselor
  • Kotzebue, AK
National Provider Identifier
1811645476
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
733 2ND Avenue
Kotzebue, AK 99752
Phone
(907) 442-7640
NPI assigned
Mar 14, 2022
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary
Professional Counselor 101YP2500X PC014285 PA

Addresses

Primary practice location

733 2ND Avenue
Kotzebue, AK 99752

Mailing address

PO Box 256
Kotzebue, AK 99752-0256
Phone (907) 442-7640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240925000840 PA Practitioner - Mental Health Counselor 0648711069 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC014285PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Directions Mental Health, PC CurrentSince Aug 5, 2024 Accepting new patients

Locations

110 Hidden Valley Rd
McMurray, PA 15317
Phone (724) 941-4040

1051 Country Club Rd
Monongahela, PA 15063
Phone (724) 237-8378

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1811645476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 256",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520256",
            "telephone_number": "907-442-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 2ND AVENUE",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "99752",
            "telephone_number": "907-442-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "TAMARA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-14",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC014285",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kotzebue, AK

Sources for this page

Verify at the official NPI Registry.