| Elizabeth Anne Booth Llc | |
|
199 W High St Somerville NJ 08876-1817 | |
| (973) 476-3520 | |
| Not Available |
| Full Name | Elizabeth Anne Booth Llc |
|---|---|
| Speciality | Social Worker |
| Location | 199 W High St, Somerville, New Jersey |
| Authorized Official Name and Position | Elizabeth Anne Booth (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9734763520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Anne Booth Llc 38 Hawthorne Ave Morris Plains NJ 07950-1709 Ph: (973) 476-3520 | Elizabeth Anne Booth Llc 199 W High St Somerville NJ 08876-1817 Ph: (973) 476-3520 |
| NPI Number | 1063847945 |
|---|---|
| Provider Enumeration Date | 09/10/2013 |
| Last Update Date | 09/10/2013 |
| Medicare PECOS PAC ID | 0244465755 |
|---|---|
| Medicare Enrollment ID | O20131108000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063847945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC00853200 (New Jersey) | Primary |
| Provider Name | Elizabeth A Booth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275618506 PECOS PAC ID: 1456392570 Enrollment ID: I20050519000293 |
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