Provider Demographics
NPI:1316257405
Name:BOYDMAN, KERRIE (LCSW)
Entity type:Individual
Prefix:
First Name:KERRIE
Middle Name:
Last Name:BOYDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 MCKNIGHT RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6007
Mailing Address - Country:US
Mailing Address - Phone:412-444-5062
Mailing Address - Fax:412-837-1893
Practice Address - Street 1:9400 MCKNIGHT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6007
Practice Address - Country:US
Practice Address - Phone:412-444-5062
Practice Address - Fax:724-625-4257
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker