Provider Demographics
NPI:1730861691
Name:BOYDEN, WILLIAM WAYNE (LCSW-E)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:WAYNE
Last Name:BOYDEN
Suffix:
Gender:M
Credentials:LCSW-E
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2534 MIDDLE AVE # A
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-2033
Mailing Address - Country:US
Mailing Address - Phone:202-210-2939
Mailing Address - Fax:
Practice Address - Street 1:2534 MIDDLE AVE # A
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2033
Practice Address - Country:US
Practice Address - Phone:202-210-2939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09060130131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical