Provider Demographics
NPI:1699942243
Name:BOOTH, KAREN (LMFT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BOOTH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11845 W OLYMPIC BLVD STE 1080
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-5023
Mailing Address - Country:US
Mailing Address - Phone:323-686-8401
Mailing Address - Fax:
Practice Address - Street 1:11845 W OLYMPIC BLVD STE 1080
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-5023
Practice Address - Country:US
Practice Address - Phone:323-686-8401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA85955101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health