Mrs Krystal Marie Boothe, LCSW | |
117 E Colorado Blvd, Pasadena, CA 91105-1938 | |
(661) 402-1545 | |
(661) 727-0006 |
Full Name | Mrs Krystal Marie Boothe |
---|---|
Gender | Female |
Speciality | Social Worker - Clinical |
Location | 117 E Colorado Blvd, Pasadena, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043488414 | NPI | - | NPPES |
9999999999 | Other | CA | BLUE CROSS |
99999999999999 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LCSW71811 (California) | Primary |
Entity Name | Wings Of The Future Private Practice Lcsw Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1144705724 PECOS PAC ID: 8729488440 Enrollment ID: O20220223000697 |
Mailing Address | Practice Location Address |
---|---|
Mrs Krystal Marie Boothe, LCSW 1308 Island Vista Dr, Arlington, TX 76005-1375 Ph: (310) 621-0150 | Mrs Krystal Marie Boothe, LCSW 117 E Colorado Blvd, Pasadena, CA 91105-1938 Ph: (661) 402-1545 |
Charles Evans, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2471 E Walnut St, Pasadena, CA 91107 Phone: 626-793-5141 | |
Melissa Mary Sagami-peck, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 210 S De Lacey Ave, Suite 110, Pasadena, CA 91105 Phone: 626-395-7100 | |
Abigail Resendiz-zuniga, MSW, ASW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 459 E Colorado Blvd, Pasadena, CA 91101 Phone: 800-488-3414 | |
Mr. Alfred Koon-ho Chow, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 447 N El Molino Ave, Pasadena, CA 91101 Phone: 626-577-8480 | |
Ms. Mari Lacressa Martin, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1520 N Raymond Ave Bldg 2-7, Pasadena, CA 91103 Phone: 626-396-5920 | |
Julie M Crenshaw, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2900 E Del Mar Blvd, Pasadena, CA 91107 Phone: 626-356-2774 | |
Margot Escudero Anderson, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 118 S Oak Knoll Ave, Pasadena, CA 91101 Phone: 626-795-6907 |