| Booth Counseling Services, P.c. | |
|
200 E Big Beaver Rd Suite 113 Troy MI 48083-1208 | |
| (248) 321-3396 | |
| Not Available |
| Full Name | Booth Counseling Services, P.c. |
|---|---|
| Speciality | Social Worker |
| Location | 200 E Big Beaver Rd, Troy, Michigan |
| Authorized Official Name and Position | Elaine Booth (PRESIDENT) |
| Authorized Official Contact | 2483213396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Booth Counseling Services, P.c. 425 Hickory Dr Troy MI 48083-1625 Ph: (248) 321-3396 | Booth Counseling Services, P.c. 200 E Big Beaver Rd Suite 113 Troy MI 48083-1208 Ph: (248) 321-3396 |
| NPI Number | 1205270212 |
|---|---|
| Provider Enumeration Date | 04/20/2013 |
| Last Update Date | 10/18/2013 |
| Medicare PECOS PAC ID | 5496989873 |
|---|---|
| Medicare Enrollment ID | O20131018000875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205270212 | NPI | - | NPPES |
| 12475344 | Other | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801058862 (Michigan) | Primary |
| Provider Name | Elaine S Booth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780778803 PECOS PAC ID: 1153584388 Enrollment ID: I20120524000698 |
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