Joshua David Booher, PHD
Individual provider Active NPI School Psychologist · Lenoir City, TN
NPI 1154320596 · NPPES record last updated Jul 26, 2007
Key facts
- NPI
- 1154320596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- 2549 (PROVISIONAL) (TN)
- Practice address
- 501 Adessa Pkwy
Ste a-150
Lenoir City, TN 37771-6725 - Phone
- (865) 986-8082
- Fax
- (865) 986-5890
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2549 (PROVISIONAL) | TN | MD | School Psychologist |
| P2549 | TN | MD | School Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | P2549 | TN | |
| School Psychologist | 103TS0200X | 2549 (PROVISIONAL) | TN | Yes |
| School Psychologist | 103TS0200X | TN |
Addresses
Primary practice location
501 Adessa Pkwy
Ste a-150
Lenoir City, TN 37771-6725
Mailing address
Department 888182
Knoxville, TN 37995-0001
Phone (800) 355-3565
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3981432 | Medicaid | TN |
Other providers in Lenoir City, TN
- Darrick Shane Blankenship
- Mary Kathleen Blankenship
- John Bockmann
- Robert James Boehm
- Alexandaria Marie Bolz
- Lori Ann Boudreaux
- Amberley Shay Boyd
- Terry Bragg
- Jacob Brashier
- Carrie Brass
All providers in Lenoir City, TN · School Psychologist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.