DIA BOUTWELL PHD
NPI 1740757731
Psychologist - Clinical in Fayetteville, GA

Q: What is Dia Boutwell's NPI number?

The NPI number for Dia Boutwell is 1740757731. It was assigned to this individual provider in the NPPES registry on October 27, 2018.

Q: What is Dia Boutwell's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Dia Boutwell was last updated on February 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 27, 2018

125 HOWARD LN STE B, FAYETTEVILLE, GA 30215(502) 867-4851 Get Directions Write a Review

NPPES record last updated: February 21, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 21, 2020, Oct 27, 2018 (2 updates tracked since 2018).

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About Dia Boutwell Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIA BOUTWELL PHD (NPI 1740757731) is an individual clinical provider in Fayetteville, Georgia, licensed in Georgia (PSY004367) and active in the NPI registry since October 2018.

NPPES Registry Identity

NPI1740757731

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDIA BOUTWELLCredential: PHD

Location Address125 HOWARD LN STE BFayetteville, GA 30215-1853

Mailing Address125 Howard Ln Ste BFayetteville, GA 30215-1853 · (502) 867-4851

Phone(502) 867-4851

Sole ProprietorYes

Enumeration DateOctober 27, 2018

Last NPPES UpdateFebruary 21, 20202 updates tracked since enumeration

✔ NPI 1740757731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in GA · PSY004367

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

125 HOWARD LN STE B, Fayetteville, GA 30215

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dia Boutwell's NPI number?

The NPI number for Dia Boutwell is 1740757731. It was assigned to this individual provider in the NPPES registry on October 27, 2018.

Where is Dia Boutwell located?

Dia Boutwell practices at 125 Howard Ln Ste B, Fayetteville, GA 30215. The listed phone number is (502) 867-4851.

What is Dia Boutwell's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Dia Boutwell was last updated on February 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.