Provider Demographics
NPI:1396324042
Name:BOYD, CRYSTAL NEWELL (LCMHCA)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:NEWELL
Last Name:BOYD
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 NO BOTTOM RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27589-9568
Mailing Address - Country:US
Mailing Address - Phone:225-213-8160
Mailing Address - Fax:
Practice Address - Street 1:2949 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1248
Practice Address - Country:US
Practice Address - Phone:919-307-9946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16377101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health