BOOTH & COMPANY, INC. (NPI# 1679694327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679694327 |
| Entity Type | Organization |
| Organization Name | BOOTH & COMPANY, INC. |
| Other Organization Name | BOOTH & COMPANY |
| Practice Address |
3240 Mallard Cove Ln Fort Wayne IN 46804-2883 |
| Practice Telephone | 2607555896 |
| Practice Fax Number | 2607555927 |
| Mailing Telephone | 2607555896 |
| Mailing Fax Number | 2607555927 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2014-01-31 |
| Authorized Official Name | DR. SPENCER JENKINS BOOTH (PRESIDENT) |
| Authorized Official Telephone | 2607555896 |
| Authorized Official Credential | PSY.D., HSPP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
20041340A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200311450 | 05 |
| Other Name | Type Code |
|---|---|
| Booth & Company | Doing Business As Name - Organization |
| Street Address |
3240 MALLARD COVE LN |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-2883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720145774 | Hutner, Inc. | Psychologist | 3240 Mallard Cove Ln, Fort Wayne, IN 46804-2883 | 2007-01-02 |
| 1417264607 | Brian Douglas Hutner | Psychologist | 3240 Mallard Cove Ln, Fort Wayne, IN 46804-2883 | 2010-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164052791 | Kadlec Consulting Services, LLC | Psychologist | 5525 Oak Valley Pl, Fort Wayne, IN 46845-1836 | 2020-01-23 |
| 1053628248 | Kelly Stewart Hutner | Psychologist | 11143 Parkview Plaza Dr Ste 320, Fort Wayne, IN 46845-1728 | 2010-09-09 |
| 1730495813 | Spencer Jenkins Booth | Psychologist | 6526 W Jefferson Blvd, Fort Wayne, IN 46804-6206 | 2010-08-26 |
| 1750519377 | Thomas Paul Dettmer | Psychologist | 6223 Constitution Dr, Fort Wayne, IN 46804-1517 | 2009-06-23 |
| 1750509667 | Casey Nelson | Psychologist | 1515 Magnavox Way, Fort Wayne, IN 46804-1533 | 2007-04-23 |
| 1982732491 | Shirley F Shiff | Psychologist | 8424 Victoria Woods Pl, Fort Wayne, IN 46825-6510 | 2007-02-28 |
| 1912080359 | Abigail Dormire Powers | Psychologist | 10311 Dawsons Creek Blvd, Suite F, Fort Wayne, IN 46825-1913 | 2006-10-21 |
| 1376593046 | Wayne James Von Bargen | Psychologist | 1910 Saint Joe Center Rd, Suite 44, Fort Wayne, IN 46825-5000 | 2006-05-11 |
| 1093774796 | Mcgee-lytle Inc | Psychologist | 2020 E Washington Blvd, Suite 650, Fort Wayne, IN 46803-1327 | 2006-03-21 |
| 1043283641 | Jason T. Cook | Psychologist | 7230 Engle Rd, Ste 304, Fort Wayne, IN 46804-2209 | 2006-02-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
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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.