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MRS. MICHELLE E. BOOTH L.C.S.W.
NPI 1861796971
Social Worker - Clinical in Fairfax, VA

Active since January 04, 2011Opted out of Medicare · through Jul 9, 2028
3900 JERMANTOWN RD STE 200, FAIRFAX, VA 22030(703) 383-8447(703) 359-6546 Get Directions Write a Review

NPPES record last updated: January 4, 2011. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Michelle E. Booth L.c.s.w. NPPES

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

MRS. MICHELLE E. BOOTH L.C.S.W. (NPI 1861796971) is an individual clinical provider in Fairfax, Virginia, licensed in Virginia (0904006947) and active in the NPI registry since January 2011. She has opted out of Medicare through July 9, 2028.

NPPES Registry Identity

NPI1861796971
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. MICHELLE E. BOOTHCredential: L.C.S.W.
Location Address3900 JERMANTOWN RD STE 200Fairfax, VA 22030-4900
Mailing Address3900 Jermantown Rd Ste 200Fairfax, VA 22030-4900 · (703) 383-8447 · Fax (703) 359-6546
Phone(703) 383-8447
Fax(703) 359-6546
Sole ProprietorNo
Enumeration DateJanuary 4, 2011
✔ NPI 1861796971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in VA · 0904006947
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.
3900 JERMANTOWN RD STE 200, Fairfax, VA 22030
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Michelle E. Booth L.c.s.w. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 9, 2026 through July 9, 2028.

Opt-Out Effective DateJuly 9, 2026
Opt-Out In Effect ThroughJuly 9, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

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

DAVID ALAN JACOBS LPC
Counselor (Addiction (Substance Use Disorder))
3900 JERMANTOWN RD STE 200
FAIRFAX, VA 22030
Fairfax City (703) 934-5475

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 Michelle Booth's NPI number?

The NPI number for Michelle Booth is 1861796971. It was assigned to this individual provider in the NPPES registry on January 4, 2011.

Where is Michelle Booth located?

Michelle Booth practices at 3900 Jermantown Rd Ste 200, Fairfax, VA 22030. The listed phone number is (703) 383-8447.

What is Michelle Booth's specialty?

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

Is Michelle Booth enrolled in Medicare?

No. Michelle Booth has opted out of Medicare through July 9, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Michelle Booth was last updated on January 4, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.