Tara Angela Booth

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1032 W Mountain Rd
Queensbury, NY 12804-8209

Phone

(518) 222-7165

NPI assigned

Oct 25, 2018

Last updated

Jul 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tara Angela Ladue Former name

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.

• Lifted Heart Mental Health Counseling, PLLC

  • Community/Behavioral Health Agency
  • Queensbury, NY
  • NPI 1790440709
  NPD Authorized official

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1366919615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 W MOUNTAIN RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128048209",
            "telephone_number": "518-222-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 W MOUNTAIN RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128048209",
            "telephone_number": "518-222-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "TARA",
        "middle_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "LADUE",
            "middle_name": "ANGELA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Judith Elisa Blakely, APRN: PSYCHIATRY
• Suzanne M Blood, MD
• Chris Ann Bocko-Wettersten, MASTERS IN EDUCATION
• Frances C Bollinger, MD
• Sarah J Bolster
• Steven John Borden, LMFT
• Meshele A Bourdeau, RN, BSN
• Mark Edwin Boyle, LICENSED OPHTHALMIC
• Mary Bozkurt
• Sarah Linn Branchfield, LMSW

• Mental Health Counselor in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.