NPIMap

Individual provider Active NPI

Theresa Marie Elitz, LPCMH, LCDP

  • Mental Health Counselor
  • Wilmington, DE
National Provider Identifier
1033449616
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC0000252 Issued in DE
Practice address
1010 W 4TH St
Wilmington, DE 19805-3602
Phone
(302) 576-4121
NPI assigned
Jan 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CD0000010 DE
Mental Health Counselor 101YM0800X PC0000252 DE Primary

Addresses

Primary practice location

1010 W 4TH St
Wilmington, DE 19805-3602

Mailing address

1010 W 4TH St
Wilmington, DE 19805-3602
Phone (302) 576-4121

Other names 1

  • Sister Theresa Marie Elitz Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CD0000010DEMDAddiction (Substance Use Disorder) Counselor
PC0000252DEMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1033449616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W 4TH ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198053602",
            "telephone_number": "302-576-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W 4TH ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198053602",
            "telephone_number": "302-576-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELITZ",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "credential": "LPCMH, LCDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "DE",
            "license": "CD0000010",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "PC0000252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SISTER THERESA",
            "last_name": "ELITZ",
            "middle_name": "MARIE",
            "credential": "LPCMH, LCDP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.