Individual provider · Type 1 NPI

Teddy Wayne Booth Ii, LCSW

Clinical Social Worker · Johnson City, TN

NPI number 1215160403 Active

Practice location

109 W Watauga Ave
Johnson City, TN 37604-5621

Call (423) 232-2600 Map

Fax (423) 467-3644

Mailing address

1167 Spratlin Park Dr
Gray, TN 37615-6205

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700X1086 (KY)
Clinical Social Worker Primary 1041C0700X3367 (TN)

Clinical Social Worker: 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 interpers…

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About NPI 1215160403

Teddy Wayne Booth Ii, LCSW's National Provider Identifier is 1215160403, issued on Sep 3, 2009. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Johnson City, TN. The record was last updated on Nov 11, 2009.