Healthcare Provider Details

I. General information

NPI: 1740513126
Provider Name (Legal Business Name): RACHEL BOOTS LMSW, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W RAILROAD ST STE A
SAINT JOHNS MI
48879-1513
US

IV. Provider business mailing address

201 W RAILROAD ST STE A
SAINT JOHNS MI
48879-1513
US

V. Phone/Fax

Practice location:
  • Phone: 989-224-5302
  • Fax:
Mailing address:
  • Phone: 989-224-5302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6801091790
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC-02645
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: