Provider Demographics
NPI:1033554258
Name:BOOTHROYD, CAROL LINDLEY (LLPC)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:LINDLEY
Last Name:BOOTHROYD
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 EASTMAN AVE
Mailing Address - Street 2:FAMILY AND CHILDREN'S SERVICES
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4216
Mailing Address - Country:US
Mailing Address - Phone:989-631-5390
Mailing Address - Fax:989-631-0488
Practice Address - Street 1:1714 EASTMAN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4216
Practice Address - Country:US
Practice Address - Phone:989-631-5390
Practice Address - Fax:989-631-0488
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2430058101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional