Active NPI
Kayla Booth, LCAS-A
- Addiction (Substance Use Disorder) Counselor
- Raleigh, NC
National Provider Identifier
1174193635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 26968
- Practice address
- 4009 Barrett Dr Ste 100
Raleigh, NC 27609-6616 - Phone
- (919) 848-0132
- NPI assigned
- Jun 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 26968 | NC | Primary |
Addresses
Primary practice location
4009 Barrett Dr Ste 100
Raleigh, NC 27609-6616
Mailing address
4009 Barrett Dr Ste 100
Raleigh, NC 27609-6616
Phone (919) 848-0132
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053535369 | Medicaid | NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26968 | NC | MD | Sports Medicine (Orthopaedic Surgery) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779321600000",
"number": "1174193635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4009 BARRETT DR STE 100",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276096616",
"telephone_number": "919-848-0132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4009 BARRETT DR STE 100",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276096616",
"telephone_number": "919-848-0132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTH",
"first_name": "KAYLA",
"credential": "LCAS-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-28",
"last_updated": "2026-05-21",
"certification_date": "2026-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "26968",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1053535369",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.