Individual provider Active NPI

Corey Alan Boothe, PSYD

  • Psychologist
  • Huntington, WV
National Provider Identifier
1801463955
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
723 9TH Ave
Huntington, WV 25701-2718
Phone
(304) 529-0645
Fax
(304) 529-3026
NPI assigned
Jun 8, 2021
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X WV Primary

Addresses

Primary practice location

723 9TH Ave
Huntington, WV 25701-2718

Mailing address

PO Box 1680
Huntington, WV 25717-1680

Other practice location 1

1301 Hal Greer Blvd
Huntington, WV 25701-3803
Phone (304) 525-0572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210713000491 WV Practitioner - Clinical Psychologist 1759783863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 1680
Huntington, WV 25717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1282WVMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Health Systems, Inc. CurrentSince Jun 21, 2021 Accepting new patients
Valley Health Systems Inc Psychologist CurrentSince Jun 21, 2021 Accepting new patients
Valley Health Systems Inc Current Accepting new patients

Locations

1301 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 525-0572

2585 3rd Ave
Huntington, WV 25703
Phone (304) 697-1396

723 9th Ave
Huntington, WV 25701
Phone (304) 529-0645

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1801463955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257171680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 9TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012718",
            "telephone_number": "304-529-0645",
            "fax_number": "304-529-3026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Hal Greer Blvd",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257013803",
            "country_code": "US",
            "telephone_number": "304-525-0572",
            "fax_number": "304-529-1119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOTHE",
        "first_name": "COREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.