Elizabeth Anne Atkinson, LPC

Key facts

NPI

1053879809

Entity type

Individual (NPI type 1)

Primary specialty

Professional Counselor 101YP2500X

Practice address

413 E Spring St
Boonville, MO 65233-1573

Phone

(660) 882-6400

NPI assigned

Mar 11, 2019

Sex

Female

Sole proprietor

Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Insight Dynamics LLC Social Worker · Boonville, MO · NPI 1710698402
  NPD
• Walking Peace Mental Health Clinic/Center (Including Community Mental Health Center) · Boonville, MO · NPI 1467289983
  NPD

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 12, 2022.

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1053879809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 RIVERSIDE DR",
            "city": "BOONVILLE",
            "state": "MO",
            "postal_code": "652331344",
            "telephone_number": "660-853-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 E SPRING ST",
            "city": "BOONVILLE",
            "state": "MO",
            "postal_code": "652331573",
            "telephone_number": "660-882-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Boonville",
            "state": "MO",
            "postal_code": "652331344",
            "country_code": "US",
            "telephone_number": "660-853-1478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S157075004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Boonville, MO · Professional Counselor in Missouri