Provider Demographics
NPI:1508747858
Name:SAM BOYD COUNSELING PLLC
Entity type:Organization
Organization Name:SAM BOYD COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:423-202-6769
Mailing Address - Street 1:6312 N PAULINA ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1148
Mailing Address - Country:US
Mailing Address - Phone:423-202-6769
Mailing Address - Fax:
Practice Address - Street 1:53 W JACKSON BLVD STE 1028
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-3648
Practice Address - Country:US
Practice Address - Phone:423-202-6769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty