Individual provider Active NPI

Elaine Mzhickteno Barr, LMSW LCAC

  • Addiction (Substance Use Disorder) Counselor
  • Mayetta, KS
National Provider Identifier
1043630650
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
335 Issued in KS
Practice address
11400 - 158TH Road
Mayetta, KS 66509-0174
Phone
(785) 966-8200
Fax
(785) 966-8386
NPI assigned
Apr 22, 2014
Last updated
Apr 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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 335 KS Primary
Social Worker 104100000X 6929 KS

Addresses

Primary practice location

11400 - 158TH Road
Mayetta, KS 66509-0174

Mailing address

PO Box 174
11400 - 158TH Road
Mayetta, KS 66509-0174
Phone (785) 966-8353

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
335KSMDMarriage & Family Therapist
6929KSMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1043630650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 174",
            "address_2": "11400 - 158TH ROAD",
            "city": "MAYETTA",
            "state": "KS",
            "postal_code": "665090174",
            "telephone_number": "785-966-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 - 158TH ROAD",
            "city": "MAYETTA",
            "state": "KS",
            "postal_code": "665090174",
            "telephone_number": "785-966-8200",
            "fax_number": "785-966-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARR",
        "first_name": "ELAINE",
        "middle_name": "MZHICKTENO",
        "name_prefix": "Mrs.",
        "credential": "LMSW LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "335",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "6929",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayetta, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; 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.