MEDICARE: DR. JENNIFER KEITH BOONE PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	PSY002996	GA

General Provider Information

NPI Number	:	1346377611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER KEITH BOONE PSY.D.

Provider Business Mailing Address
First Line	:	3434 WOODSHIRE XING
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-8720
Country	:	US
Telephone Number	:	404-274-0387
Fax Number	:

Provider Business Practice Location Address
First Line	:	750 HAMMOND DR.
Second Line	:	#6 SUITE 350
City	:	ATLANTA
State	:	GA
Zip	:	30328
Country	:	US
Telephone Number	:	404-585-4940
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	01/07/2026

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