LORI GRAY BOOTHROYD PLLC NPI 1508001090

NPI Information

  • NPI: 1508001090
  • Provider Name: LORI GRAY BOOTHROYD PLLC
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • Address: 12935 S WEST BAY SHORE DR
    SUITE 200
    TRAVERSE CITY, MI
    ZIP 49684
  • Phone: (231) 929-4722

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NPI Details

LORI GRAY BOOTHROYD PLLC is a community behavioral health in Traverse City, MI. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. LORI GRAY BOOTHROYD PLLC NPI is 1508001090. The provider is registered as an organization entity type.

The provider's business location address is:

12935 S WEST BAY SHORE DR
SUITE 200
TRAVERSE CITY, MI
ZIP 49684-298
Phone: (231) 929-4722

The provider's authorized official is Lori Boothroyd .
The authorized official title is Licensed Psychologist and has the following contact phone number (231) 929-4722.

The enumeration date for this NPI number is 12/11/2008 and was last updated on 8/10/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral Health6301012397MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1MI1793MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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