Active NPI
Lisa Elisofon Booth
- Behavior Technician
- Columbia, MD
National Provider Identifier
1447755194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 8815 Columbia 100 Pkwy Ste 4
Columbia, MD 21045-2361 - Phone
- (877) 776-8502
- NPI assigned
- Mar 26, 2018
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
8815 Columbia 100 Pkwy Ste 4
Columbia, MD 21045-2361
Mailing address
6026 River Birch CT
Hanover, MD 21076-1058
Phone (443) 956-0196
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164-961-7952 | Other | CHILDREN'S SPOT |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Children'S Spot | Past | Accepting new patients | |
| Spot for Speech and Occupational Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Occupational Therapist
- Columbia, MD
- NPI 1194387498
-
- Speech-Language Pathologist
- Columbia, MD
- NPI 1649617952
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522022400000",
"number": "1447755194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6026 RIVER BIRCH CT",
"city": "HANOVER",
"state": "MD",
"postal_code": "210761058",
"telephone_number": "443-956-0196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8815 COLUMBIA 100 PKWY STE 4",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210452361",
"telephone_number": "877-776-8502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTH",
"first_name": "LISA",
"middle_name": "ELISOFON",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-26",
"last_updated": "2018-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHILDREN'S SPOT",
"identifier": "164-961-7952",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.