Active NPI
Anna Ruth Booth, MA
- Mental Health Counselor
- Lake Oswego, OR
National Provider Identifier
1750437117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 15110 Boones Ferry Rd Ste 240
Lake Oswego, OR 97035 - Phone
- (503) 781-6938
- Fax
- (503) 230-8884
- NPI assigned
- Jan 26, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
15110 Boones Ferry Rd Ste 240
Lake Oswego, OR 97035
Mailing address
15110 Boones Ferry Rd Ste 240
Lake Oswego, OR 97035-3497
Phone (503) 781-6938
Other practice location 1
11035 NE Sandy Blvd
Portland, OR 97220-2553
Phone (503) 258-4161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500664078 | Medicaid | OR |
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
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morrison Child and Family Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, OR
- NPI 1346382975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564012800000",
"number": "1750437117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15110 BOONES FERRY RD STE 240",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970353497",
"telephone_number": "503-781-6938",
"fax_number": "503-230-8884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15110 BOONES FERRY RD STE 240",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "97035",
"telephone_number": "503-781-6938",
"fax_number": "503-230-8884"
}
],
"practiceLocations": [
{
"address_1": "11035 NE Sandy Blvd",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972202553",
"country_code": "US",
"telephone_number": "503-258-4161",
"fax_number": "503-230-8884",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOOTH",
"first_name": "ANNA",
"middle_name": "RUTH",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2019-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500664078",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.