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General NPI Number Information
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NPI Number | 1184968810
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Entity Type | Individual
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Provider Name | NAOMI BOOTHE LPC/MHSP, MAC, NCC
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Gender | Female
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 05/02/2017
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Provider Practice Location Address
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Address Line | 1222 TREMONT ST SUITE 100
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City | CHATTANOOGA
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State | TN
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Zip | 37405-3038
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Country | US
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Telephone | 423-847-2535
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Fax |
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Provider Business Mailing Address
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Address Line | 1614 RIO VISTA DR
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City | DALTON
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State | GA
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Zip | 30720-5147
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Country | US
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Telephone | 423-650-9101
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC0000002685
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License Number State | TN
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