Michelle Booth, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904006947 Issued in VA

Legal business name

MICHELLE BOOTH, LCSW

Practice address

10560 Main St
Suite 405
Fairfax, VA 22030-7182

Phone

(571) 477-0096

NPI assigned

Dec 15, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle E. Booth, LCSW

Title

Psychotherapist

Phone

(571) 477-0096

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418601600000",
    "number": "1851799324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 POLLEN ST",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220791639",
            "telephone_number": "703-339-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 MAIN ST",
            "address_2": "SUITE 405",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307182",
            "telephone_number": "571-477-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE BOOTH, LCSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-15",
        "last_updated": "2014-12-15",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "571-477-0096",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.