BOOTH & COMPANY - NPI 1679694327 - Psychologist in Fort Wayne, IN

Q: What is Booth & Company, Inc.'s NPI number?

The NPI number for Booth & Company, Inc. is 1679694327. It was assigned to this organization in the NPPES registry on April 2, 2007. The provider is doing business as Booth & Company and Great Lakes Psychological Assessment.

Q: What is Booth & Company, Inc.'s specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

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About Booth & Company NPPES

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

BOOTH & COMPANY (NPI 1679694327) is a healthcare organization registered as a clinical in Fort Wayne, Indiana and active in the NPI registry since April 2007. The organization lists Spencer Jenkins Booth, President, as its authorized official.

NPPES Registry Identity

NPI1679694327

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameBOOTH & COMPANY, INC.

Location Address9329 ILLINOIS RDFort Wayne, IN 46804-5796

Mailing Address9329 Illinois RdFort Wayne, IN 46804-5796 · (260) 755-5896 · Fax (260) 755-5927

Phone(260) 755-5896

Fax(260) 755-5927

Organization SubpartNo

Authorized OfficialSpencer Jenkins BoothPresident · (260) 417-4885

Enumeration DateApril 2, 2007

Last NPPES UpdateOctober 1, 2024

NPPES CertifiedOctober 1, 2024

✔ NPI 1679694327 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IN · 20041340A

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

9329 ILLINOIS RD, Fort Wayne, IN 46804

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Other Names 2

Doing Business AsBooth & Company

Doing Business AsGreat Lakes Psychological Assessment

Other Identifiers 1

Medicaid200311450IN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

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

SAM BOOTH M.A.

Counselor (Mental Health)