Carly R Booth, MSW LCAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

4437 Main St
Shallotte, NC 28470-4451

Phone

(910) 754-4449

NPI assigned

Jun 22, 2020

Last updated

Dec 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Treatment Centers LLC

  • Community/Behavioral Health Agency
  • Shallotte, NC
  • NPI 1033915509
  NPD
• Treatment Centers LLC

  • Community/Behavioral Health Agency
  • Lexington, NC
  • NPI 1639592900
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1134745516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4437 MAIN ST",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704451",
            "telephone_number": "910-754-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4437 MAIN ST",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704451",
            "telephone_number": "910-754-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "CARLY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MSW LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Family Medicine PLLC
• John A Blake, PA-C
• Blue Ridge Health and Spine, PLLC (Family First Health Center)
• Morgan Frances Bobb, DPT, PT
• Joan Sebastian Bolanos Lopez, PA-C
• Benjamin Houston Bowden, MSN FNP-C
• Mary Elizabeth Bowers, FNP
• Jonathan Earl Bowling, O.D.
• Mary Elizabeth Boyer
• Joshua Boyle

• Addiction (Substance Use Disorder) Counselor in Shallotte, NC
• Providers in Shallotte, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.