Individual provider Active NPI

Bethea Elizabeth Loeb, LMHC

  • Mental Health Counselor
  • Waterloo, IA
National Provider Identifier
1063796993
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001313 Issued in IA
Practice address
3136 Brockway Rd
Suite B
Waterloo, IA 50701-5103
Phone
(319) 232-2086
Fax
(319) 232-6846
NPI assigned
Oct 11, 2011
Last updated
Oct 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 001313 IA Primary

Addresses

Primary practice location

3136 Brockway Rd
Suite B
Waterloo, IA 50701-5103

Mailing address

3136 Brockway Rd
Suite B
Waterloo, IA 50701-5103
Phone (319) 232-2086

Other names 1

  • Bethea Elizabeth Woodsmall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240328000551 IA Practitioner - Mental Health Counselor 8921451998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Covenant Medical Center IncGroup PAC ID 0244148732, 234 clinicians

Practice addresses (Care Compare)

226 Bluebell Rd
Cedar Falls, IA 50613-6328
Phone (319) 575-5800

2802 Orchard Dr
Cedar Falls, IA 50613-5898
Phone (319) 268-9700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001313IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center Inc CurrentSince Mar 11, 2024 Accepting new patients
Covenant Medical Center, Inc. CurrentSince Mar 11, 2024 Accepting new patients
New Directions Counseling Services, PLLC. Past Accepting new patients

Locations

226 Bluebell Rd
Cedar Falls, IA 50613
Phone (319) 575-5800

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-7050

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1063796993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 BROCKWAY RD",
            "address_2": "SUITE B",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015103",
            "telephone_number": "319-232-2086",
            "fax_number": "319-232-6846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3136 BROCKWAY RD",
            "address_2": "SUITE B",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015103",
            "telephone_number": "319-232-2086",
            "fax_number": "319-232-6846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEB",
        "first_name": "BETHEA",
        "middle_name": "ELIZABETH",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHEA",
            "last_name": "WOODSMALL",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.