Individual provider Active NPI

Amira C Boylston, PH.D.

  • School Psychologist
  • Crofton, MD
National Provider Identifier
1932850468
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
2138 Priest Bridge CT
Crofton, MD 21114-2462
Phone
(443) 584-6773
NPI assigned
Jan 17, 2022
Last updated
May 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X A0651 MD
School Psychologist 103TS0200X MD Primary

Addresses

Primary practice location

2138 Priest Bridge CT
Crofton, MD 21114-2462

Mailing address

2138 Priest Bridge CT Ste 1
Crofton, MD 21114-2463
Phone (443) 584-6773

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
A0651MDMDCognitive & Behavioral Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1932850468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 PRIEST BRIDGE CT STE 1",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142463",
            "telephone_number": "443-584-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 PRIEST BRIDGE CT",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142462",
            "telephone_number": "443-584-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLSTON",
        "first_name": "AMIRA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-17",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MD",
            "license": "A0651",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.