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General NPI Number Information
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NPI Number | 1134550361
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Entity Type | Individual
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Provider Name | EMILY ELNORA BOOTH LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/13/2013
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 300 OXFORD DR STE 110
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City | MONROEVILLE
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State | PA
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Zip | 15146-2361
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Country | US
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Telephone | 724-309-1903
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 CHARLIE HALL BLVD
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City | CHARLESTON
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State | SC
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Zip | 29414-5832
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 9918
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW018959
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License Number State | PA
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