Active NPI
Michelle Mustian Boyd, LCSW
- Clinical Social Worker
- Ahoskie, NC
National Provider Identifier
1821135765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C003469
- Practice address
- 220 Baker St W
Ahoskie, NC 27910-2212 - Phone
- (252) 332-7712
- NPI assigned
- Jan 31, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C003469 | NC | Primary |
Addresses
Primary practice location
220 Baker St W
Ahoskie, NC 27910-2212
Mailing address
PO Box 802
Ahoskie, NC 27910-0802
Phone (252) 332-7712
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6003550 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C003469 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188864000000",
"number": "1821135765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 802",
"city": "AHOSKIE",
"state": "NC",
"postal_code": "279100802",
"telephone_number": "252-332-7712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 BAKER ST W",
"city": "AHOSKIE",
"state": "NC",
"postal_code": "279102212",
"telephone_number": "252-332-7712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "MICHELLE",
"middle_name": "MUSTIAN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2007-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C003469",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6003550",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ahoskie, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.