Active NPI
Elizabeth Ann Minnich, LCMHC, LCAS
- Professional Counselor
- Myrtle Beach, SC
National Provider Identifier
1063805414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A11356
- Practice address
- 3100 Dick Pond Rd Ste E-3
Myrtle Beach, SC 29588-7286 - Phone
- (919) 637-9418
- NPI assigned
- Mar 10, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 21213 | NC | |
| Professional Counselor | 101YP2500X | A11356 | NC | Primary |
Addresses
Primary practice location
3100 Dick Pond Rd Ste E-3
Myrtle Beach, SC 29588-7286
Mailing address
3100 Dick Pond Rd Ste E-3
Myrtle Beach, SC 29588-7286
Phone (919) 637-9418
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 20, 2024 through Jan 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21213 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| A11356 | NC | MD | Professional Counselor |
Interoperability endpoints
- liz.minnich@direct.evergreencounselingnc.nchie.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674172800000",
"number": "1063805414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 DICK POND RD STE E-3",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295887286",
"telephone_number": "919-637-9418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 DICK POND RD STE E-3",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295887286",
"telephone_number": "919-637-9418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINNICH",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LCMHC, LCAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-10",
"last_updated": "2023-01-20",
"certification_date": "2023-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "21213",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A11356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.