| Michelle Booth, Lcsw | |
|
10560 Main St Suite 405 Fairfax VA 22030-7182 | |
| (571) 477-0096 | |
| Not Available |
| Full Name | Michelle Booth, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 10560 Main St, Fairfax, Virginia |
| Authorized Official Name and Position | Michelle E. Booth (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5714770096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Booth, Lcsw 7514 Pollen St Lorton VA 22079-1639 Ph: (703) 339-8845 | Michelle Booth, Lcsw 10560 Main St Suite 405 Fairfax VA 22030-7182 Ph: (571) 477-0096 |
| NPI Number | 1851799324 |
|---|---|
| Provider Enumeration Date | 12/15/2014 |
| Last Update Date | 12/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851799324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904006947 (Virginia) | Primary |
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