JACK H BOOTH (NPI# 1548291842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548291842 |
| Entity Type | Individual |
| Full Name | JACK H BOOTH |
| Credential | PSY.D, LPC |
| Practice Address |
709 Old Trolley Rd Summerville SC 29485-5203 |
| Practice Telephone | 8438212480 |
| Practice Fax Number | 8438753149 |
| Mailing Telephone | 8438212480 |
| Mailing Fax Number | 8438753149 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
2674 | SC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982765152 | Jack Branyon Booth | Otolaryngology | 930 Bethesda Dr. Bldg 4, Zanesville, OH 43701-0815 | 2006-12-12 |
| Street Address |
709 OLD TROLLEY RD |
| City | SUMMERVILLE |
| State | SC |
| Zip Code | 29485-5203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376593376 | Anna Conner Polk | Counselor | 709 Old Trolley Rd, Summerville, SC 29485-5203 | 2006-05-11 |
| 1558885400 | James Fox Md, LLC | Psychiatry & Neurology | 709 Old Trolley Rd, Summerville, SC 29485-5203 | 2017-08-02 |
| 1497179295 | Susan S. Crocker, M.d., LLC | Psychiatry & Neurology | 709 Old Trolley Rd, Summerville, SC 29485-5203 | 2014-02-13 |
| 1861709685 | Counseling and Consultation Services of The Carolinas, LLC | Counselor | 709 Old Trolley Rd, Summerville, SC 29485-5203 | 2010-09-01 |
| 1003092511 | Brian D Musolf | Counselor | 709 Old Trolley Rd, Summerville, SC 29485-5203 | 2008-01-15 |
| 1033245634 | C J Jones Enterprises Pa | Psychiatry & Neurology | 709 Old Trolley Rd, Summerville, SC 29485-5203 | 2007-02-26 |
| 1083758387 | William H Burke | Counselor | 709 Old Trolley Rd, Summerville, SC 29485-5203 | 2007-02-19 |
| 1952445256 | Rhonda Williams Burke | Counselor | 709 Old Trolley Rd, Summerville, SC 29485-5203 | 2007-02-19 |
| 1245252774 | Melinda Edwards | Psychiatry & Neurology | 709 Old Trolley Rd, Summerville, SC 29485-5203 | 2006-07-24 |
| 1669407847 | Christopher J Jones | Psychiatry & Neurology | 709 Old Trolley Rd, Summerville, SC 29485-5203 | 2006-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487267365 | Cp Dentistry, LLC | Dentist | 9919 Dorchester Road, Summerville, SC 29485 | 2020-08-28 |
| 1922622604 | Rachel Elaine Digiacomo | Physical Therapist | 10160 Dorchester Road, Summerville, SC 29485 | 2020-05-29 |
| 1396220034 | Amanda W Peebles | Nurse Practitioner | 4278 Ladson Rd., Summerville, SC 29485 | 2018-09-28 |
| 1396230728 | Gerald Darnell Woods | Counselor | 10825 Dorchester Rd. #3077, Summerville, SC 29485 | 2018-06-27 |
| 1063901072 | Elite Barber Spa, LLC | Specialist | 850 E Bacons Bridge Road, Suite 303, Summerville, SC 29485 | 2018-05-04 |
| 1598253528 | Daniel Joseph Neitzke | Student in an Organized Health Care Education/Training Program | 9228 Medical Plaza Drive, Charleston, SC 29485 | 2018-04-25 |
| 1700315447 | Donna Marie White | Counselor | 9214 Ayscough Road, Summerville, SC 29485 | 2017-06-07 |
| 1043763212 | Brockman Davis Smith | Dentist | 1710 B Trolley Road, Summerville, SC 29485 | 2016-07-25 |
| 1336508530 | Meca Home Health, LLC | Home Health | 415 Savannah River Rd, Summerville, SC 29485 | 2016-02-16 |
| 1609241033 | Dental Professionals of South Carolina, PC | Dentist | 9510 Dorchester Rd, Suite 400, North Charleston, SC 29485 | 2015-12-10 |
| Find all providers in zip 29485 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740880061 | Pledger Behavior Consulting, LLC | Counselor | 7563 Highway 337, Summerville, GA 30747-6101 | 2020-10-27 |
| 1073126090 | Colleen Catherine Lhotsky Sullivan | Counselor | 209 Yeamans Way, Summerville, SC 29483-9770 | 2020-08-28 |
| 1437773983 | Te'on Grant | Counselor | 89b Old Trolley Rd, Summerville, SC 29485-4933 | 2020-06-01 |
| 1255979431 | Jeanette Louise Virden | Counselor | 200 E 5th North Street, Summerville, SC 29483 | 2019-12-18 |
| 1083181424 | Laurie Michael Tomlin | Counselor | 235 Medford Dr, Summerville, SC 29485-6507 | 2018-10-24 |
| 1912498650 | Linda A Wolf | Counselor | 173 Braly Dr, Summerville, SC 29485-5317 | 2018-05-29 |
| 1942714365 | Amy Adler | Counselor | 1317m N Main St, Ste 318, Summerville, SC 29483-7307 | 2017-11-21 |
| 1750716304 | Crystal Schulze | Counselor | 1668 Old Trolley Rd Ste 203, Summerville, SC 29485 | 2013-09-13 |
| 1013358621 | Lori M Gant | Counselor | 200 W. 5th North Street, Suite C, Summerville, SC 29483-6512 | 2013-07-11 |
| 1073858031 | Anthony Wade Finke | Counselor | 239 Cameron St, Summerville, SC 29483-5362 | 2012-12-03 |
| Find all providers in SUMMERVILLE | ||||
| City | SUMMERVILLE |
| Zip Code | 29485 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.