Provider Demographics
NPI:1063380103
Name:BOYD, SHAWNA TAYLOR (LMSW)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:TAYLOR
Last Name:BOYD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2188 DREW VALLEY RD NE # NA
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3918
Mailing Address - Country:US
Mailing Address - Phone:404-626-8222
Mailing Address - Fax:404-626-8222
Practice Address - Street 1:2188 DREW VALLEY RD NE # NA
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-3918
Practice Address - Country:US
Practice Address - Phone:404-626-8222
Practice Address - Fax:404-626-8222
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-29
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW008949104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker