Provider Demographics
NPI:1699894121
Name:BOYD, VANESSA (LPC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8461 TURNPIKE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-4378
Mailing Address - Country:US
Mailing Address - Phone:720-540-0536
Mailing Address - Fax:720-540-0535
Practice Address - Street 1:8461 TURNPIKE DR STE 105
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-4378
Practice Address - Country:US
Practice Address - Phone:720-540-0536
Practice Address - Fax:720-540-0535
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC-3986101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO5488061Medicaid