Provider Demographics
NPI:1154529147
Name:BOYD, MARNIE M (LPC-I)
Entity type:Individual
Prefix:MS
First Name:MARNIE
Middle Name:M
Last Name:BOYD
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 KENSINGTON LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-4506
Mailing Address - Country:US
Mailing Address - Phone:512-767-3555
Mailing Address - Fax:512-828-6150
Practice Address - Street 1:301 KENSINGTON LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-4506
Practice Address - Country:US
Practice Address - Phone:512-767-3555
Practice Address - Fax:512-828-6150
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58429101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional