Brenda B Booth, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP 4265 Issued in OH

Practice address

1885 Lake Ave
Elyria, OH 44035-2551

Phone

(440) 233-2271

NPI assigned

Feb 13, 2014

Last updated

May 9, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Brenda B Duerk Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1962826826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 OAKDALE DR",
            "city": "SOUTH AMHERST",
            "state": "OH",
            "postal_code": "440012846",
            "telephone_number": "440-986-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 LAKE AVE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440352551",
            "telephone_number": "440-233-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "BRENDA",
        "middle_name": "B",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-13",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP 4265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "DUERK",
            "middle_name": "B",
            "credential": "MA CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allen Bohannon, LSW
• Jenelle Lynn Bolzan, PHARMD
• Teresa Bonness, LPN
• Sarah Michelle Bookshar
• Kelley Boole
• Gregory Boris
• Troy D Bornhorst, O.D.
• Allison Leann Borstad, MSW, LSW
• Gabrielle A Bowen
• Timothy Nathan Boyd

• Speech-Language Pathologist in Elyria, OH
• Providers in Elyria, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.