Provider Demographics
NPI:1588091094
Name:BOYKIN, ELIZABETH MISSEY (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MISSEY
Last Name:BOYKIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:LORRAINE
Other - Last Name:MISSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:2000 PERIMETER PARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:919-570-7708
Mailing Address - Fax:919-570-5877
Practice Address - Street 1:11200 GOVERNOR MANLY WAY
Practice Address - Street 2:SUITE 205
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8599
Practice Address - Country:US
Practice Address - Phone:919-570-7708
Practice Address - Fax:919-570-5877
Is Sole Proprietor?:No
Enumeration Date:2013-09-28
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0095541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical