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TEDDY WAYNE BOOTH II LCSW
NPI 1215160403
Social Worker - Clinical in Johnson City, TN

Active since September 03, 2009
109 W WATAUGA AVE, JOHNSON CITY, TN 37604(423) 232-2600(423) 467-3644 Get Directions Write a Review

NPPES record last updated: November 11, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Teddy Wayne Booth Ii Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TEDDY WAYNE BOOTH II LCSW (NPI 1215160403) is an individual clinical provider in Johnson City, Tennessee, licensed in Tennessee (3367) and active in the NPI registry since September 2009.

NPPES Registry Identity

NPI1215160403
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameTEDDY WAYNE BOOTH IICredential: LCSW
Location Address109 W WATAUGA AVEJohnson City, TN 37604-5621
Mailing Address1167 Spratlin Park DrGray, TN 37615-6205 · (423) 467-3600 · Fax (423) 467-3644
Phone(423) 232-2600
Fax(423) 467-3644
Sole ProprietorYes
Enumeration DateSeptember 3, 2009
Last NPPES UpdateNovember 11, 2009
✔ NPI 1215160403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in TN · 3367✔ Licensed in KY · 1086
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

109 W WATAUGA AVE, Johnson City, TN 37604
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Other Identifiers 4

Medicare UPIN021250F70VA
Medicare UPIN103I801230TN
Medicaid1515202TN
Medicaid1215160403 WATAUGAVA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. TRISHA MCCALMONT WHITLOCK MA
Counselor
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2700
LISA ANN FORBES MED
Counselor
109 W WATAUGA AVE, WATAUGA BEHAVIORAL HEALTH SERVICES
JOHNSON CITY, TN 37604
Washington County (423) 232-2700
MS. PAMELA KAY FORD BS
Case Manager/Care Coordinator
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2700
KRISTI KAREN KELLY BSW
Case Manager/Care Coordinator
109 W WATAUGA AVE, WATAUGA BEHAVIORAL HEALTH SERVICES
JOHNSON CITY, TN 37604
Washington County (423) 232-2700
MR. EDWARD REX CROSS III BS
Case Manager/Care Coordinator
109 W WATAUGA AVE, WATAUGA C & Y
JOHNSON CITY, TN 37604
Washington County (423) 232-2700
MRS. LAURA ANN KELLICUT MA
Counselor (Professional)
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
VIRGINIA SUSAN PATTON BSW
Case Manager/Care Coordinator
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2658
LISA MARIE LOVELACE BSW
Case Manager/Care Coordinator
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2791

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Teddy Booth's NPI number?

The NPI number for Teddy Booth is 1215160403. It was assigned to this individual provider in the NPPES registry on September 3, 2009.

Where is Teddy Booth located?

Teddy Booth practices at 109 W Watauga Ave, Johnson City, TN 37604. The listed phone number is (423) 232-2600.

What is Teddy Booth's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Teddy Booth was last updated on November 11, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.