Provider Demographics
NPI:1043480999
Name:BOYD, ANGELA CS (MDIV, MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:CS
Last Name:BOYD
Suffix:
Gender:F
Credentials:MDIV, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SYLVAN LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-2033
Mailing Address - Country:US
Mailing Address - Phone:609-531-6143
Mailing Address - Fax:866-240-9877
Practice Address - Street 1:1848 BURLINGTON MOUNT HOLLY RD
Practice Address - Street 2:# 541
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-1068
Practice Address - Country:US
Practice Address - Phone:609-531-6143
Practice Address - Fax:866-240-9877
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055413001041C0700X
MELC120911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical