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Mica Collins Booth

Speech-Language Pathologist β€’ Lady Lake, FL

Active NPI 1073835666 Individual Practitioner Female Practitioner
Practice location in NPPES

630 Griffin Ave
Lady Lake, FL 321598101

Call 3527506619 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

630 Griffin Ave

Lady Lake, FL 321598101

Telephone 3527506619
Organization at the Same NPPES Address or Phone
Lady Lake Nh, Llc Facility NPI 1326043050

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Summerfield, FL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2010

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Lady Lake and Florida

7 active clinicians are listed under Speech-Language Pathologist with a practice address in Lady Lake, FL (11,513 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-04-24
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES FL SA10301

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Secondary Practice Locations

9377 Se 164th Pl

Summerfield, FL 344915898

Phone: 2292697251

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Michael Green , PA-C

Physician Assistant

NPI 1730257981

Physician Assistant (Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location April 24, 2025

Registered at 630 GRIFFIN AVE, LADY LAKE, FL 321598101 (Tel: 3527506619)

πŸ“
Updated Business Mailing Address April 24, 2025

Registered at 630 GRIFFIN AVE, LADY LAKE, FL 321598101 (Tel: 3527506619)

πŸ‘€
Provider Name / Credentials Updated April 24, 2025

Recorded as MICA BOOTH

βœ…
NPI Profile Active February 23, 2010

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 23, 2010

Registered at 245 CAHABA VALLEY PKWY STE 200, PELHAM, AL 351242217 (Tel: 2059426820)

πŸ“
Business Mailing Address (Initial Record) February 23, 2010

Registered at 1201 SE 24TH RD, OCALA, FL 344716009

πŸ‘€
Provider Name / Credentials (Initial Record) February 23, 2010

Recorded as MICA MINK

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 23, 2010

Speech-Language Pathologist (license number reported to NPPES: FL SA10301)

🟒
Initial NPI Registration & Enumeration February 23, 2010

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1073835666
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 23, 2010
Last Update: April 24, 2025
Sole Proprietor: No

Mailing Address

630 Griffin Ave

Lady Lake, FL 321598101

Phone: 3527506619

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.