Active NPI
Thomas C. Booth, MA
- Mental Health Counselor
- Lincoln, NE
National Provider Identifier
1144394180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2987
- Practice address
- 210 Gateway Mall
#342 Greentree Court
Lincoln, NE 68505-2489 - Phone
- (402) 434-2730
- NPI assigned
- Nov 20, 2006
- Last updated
- Jan 23, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0013 | NE | |
| Mental Health Counselor | 101YM0800X | 2987 | NE | Primary |
| Professional Counselor | 101YP2500X | 1547 | NE |
Addresses
Primary practice location
210 Gateway Mall
#342 Greentree Court
Lincoln, NE 68505-2489
Mailing address
210 Gateway Mall
#342 Greentree Court
Lincoln, NE 68505-2489
Phone (402) 434-2730
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85540 | Other | NE | BLUE CROSS & BLUE SHIELD |
| 68505A008 | Other | NE | TRICARE |
| 47075636930 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0013 | NE | MD | Addiction (Substance Use Disorder) Counselor |
| 2987 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201046400000",
"number": "1144394180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 GATEWAY MALL",
"address_2": "#342 GREENTREE COURT",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685052489",
"telephone_number": "402-434-2730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 GATEWAY MALL",
"address_2": "#342 GREENTREE COURT",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685052489",
"telephone_number": "402-434-2730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTH",
"first_name": "THOMAS",
"middle_name": "C.",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2008-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NE",
"license": "0013",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "2987",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NE",
"license": "1547",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "85540",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "68505A008",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47075636930",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.