Provider Demographics
NPI:1699479386
Name:BOYD, SUMMER (PSYD)
Entity type:Individual
Prefix:DR
First Name:SUMMER
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-1823
Mailing Address - Country:US
Mailing Address - Phone:602-340-8717
Mailing Address - Fax:602-606-9870
Practice Address - Street 1:2225 N 16TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-1823
Practice Address - Country:US
Practice Address - Phone:602-340-8717
Practice Address - Fax:602-606-9870
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005656103TC0700X, 103T00000X
103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent