Patrick Robert Booth, M.S.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-35356 Issued in NV

Practice address

4055 Spencer St Ste 118
Las Vegas, NV 89119-5250

Phone

(702) 799-9710

NPI assigned

Jul 6, 2012

Last updated

Jul 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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.

• Desert Behavioral Health

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1467785527
  NPD
• LKBG LLC

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1326453838
  NPD (past)
• Tandem Therapy Services

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1215056478
  NPD (past)
• Tandem Therapy Services

  • Speech-Language Pathologist
  • Las Vegas, NV
  • NPI 1356724652
  NPD (past)

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1639434582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 W CHARLESTON BLVD",
            "address_2": "SUITE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171636",
            "telephone_number": "702-396-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 SPENCER ST STE 118",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195250",
            "telephone_number": "702-799-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "PATRICK",
        "middle_name": "ROBERT",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NV",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "1-19-35356",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NV",
            "license": "RBT-16-16491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phayvanh Boonsiri
• Pornpimon Boonyakiat, M.D.
• Andrew Booth
• Kimberlee Booth
• Margaretta Booth
• Dina Boothe
• Anysia Lynae Boozer
• Mariah Boozer
• Kelaydin Hormozi Borashan
• Austin David Borba

• Behavior Analyst in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Behavior Analyst in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.