Provider Demographics
NPI:1700181831
Name:BOOTH, TORY L (MA, LMFT, ATR)
Entity Type:Individual
Prefix:MRS
First Name:TORY
Middle Name:L
Last Name:BOOTH
Suffix:
Gender:F
Credentials:MA, LMFT, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 MISSION HIIL RD.
Mailing Address - Street 2:TULALIP TRIBES- BEHAVIORAL HEALTH
Mailing Address - City:TULALIP
Mailing Address - State:WA
Mailing Address - Zip Code:98271-9706
Mailing Address - Country:US
Mailing Address - Phone:360-716-4224
Mailing Address - Fax:360-716-0751
Practice Address - Street 1:2828 MISSION HILL RD
Practice Address - Street 2:TULALIP TRIBES- BEHAVIORAL HEALTH
Practice Address - City:TULALIP
Practice Address - State:WA
Practice Address - Zip Code:98271-9706
Practice Address - Country:US
Practice Address - Phone:360-716-3284
Practice Address - Fax:360-716-0705
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF 603277725106H00000X
WACG60201811101YM0800X, 101Y00000X
WALF60327725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor