Provider Demographics
NPI:1437851698
Name:BOOTSMA, ALAYNA MARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:ALAYNA
Middle Name:MARIE
Last Name:BOOTSMA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 BARNARD RD
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-4428
Mailing Address - Country:US
Mailing Address - Phone:941-313-6810
Mailing Address - Fax:
Practice Address - Street 1:2904 BARNARD RD
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-4428
Practice Address - Country:US
Practice Address - Phone:941-313-6810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21998101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health