Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Teddy Wayne Booth II, LCSW

Individual provider Clinical Social Worker · NPI 1215160403

Teddy Wayne Booth II, LCSW is a Clinical Social Worker in Johnson City, Tennessee. Practices as a sole proprietor. Licensed in Kentucky and Tennessee.

Licensed in
KY, TN
In the registry since
2009
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

109 W Watauga Ave
Johnson City, TN 37604-5621
Phone: (423) 232-2600
Fax: (423) 467-3644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 3367 (TN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 1086 (KY)

Record details

NPI number1215160403
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedSeptember 3, 2009
Last updated in NPPESNovember 11, 2009

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