Individual provider Active NPI

Jeralyn Boyd, MA, LISW

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1962825687
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I. 1700101 Issued in OH
Practice address
7162 Reading Rd Ste 500
Cincinnati, OH 45237-3899
Phone
(513) 761-6222
Fax
(513) 679-4590
NPI assigned
Jan 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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 I. 1700101 OH Primary

Addresses

Primary practice location

7162 Reading Rd Ste 500
Cincinnati, OH 45237-3899

Mailing address

8425 Cottonwood Dr Apt 3
Cincinnati, OH 45231-5930
Phone (513) 499-1765

Other practice location 1

430 Reading Rd Ste 300
Cincinnati, OH 45202
Phone (513) 499-1765

Other identifiers 1

IdentifierTypeStateIssuer
0205946MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170309002092 OH Practitioner - Clinical Social Worker 9830473925 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

430 Reading Rd
Suite 300
Cincinnati, OH 45202-1460
Phone (513) 709-7759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
I. 1700101OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jr Gatt, LLC Clinical CurrentSince Jul 1, 2020 Accepting new patients
Talbert House CurrentSince Feb 10, 2017 Accepting new patients
Mental Cleanse Therapeutic & Consulting Services LLC Clinical PastSince Sep 24, 2023 Accepting new patients

Locations

2600 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 872-5863

1515 Carll St
Cincinnati, OH 45225
Phone (513) 244-3985

430 Reading Rd
Ste 300
Cincinnati, OH 45202
Phone (513) 213-0056

7162 Reading Rd
Ste 500
Cincinnati, OH 45237
Phone (513) 679-4586

1118 Pendleton St
Ste 440
Cincinnati, OH 45202
Phone (513) 494-8191

Organizations & group practices 3

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": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1962825687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8425 COTTONWOOD DR APT 3",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452315930",
            "telephone_number": "513-499-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7162 READING RD STE 500",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452373899",
            "telephone_number": "513-761-6222",
            "fax_number": "513-679-4590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 Reading Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "45202",
            "country_code": "US",
            "telephone_number": "513-499-1765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "JERALYN",
        "name_prefix": "Mrs.",
        "credential": "MA, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-31",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I. 1700101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0205946",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.