Individual provider Active NPI

Elizabeth Grace McCann, APCC

  • Mental Health Counselor
  • Novato, CA
National Provider Identifier
1083810139
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5134 Issued in CA
Practice address
1682 Novato Blvd
Novato, CA 94947
Phone
(415) 305-8004
NPI assigned
Jun 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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 5134 CA Primary

Addresses

Primary practice location

1682 Novato Blvd
Novato, CA 94947

Mailing address

20 N San Pedro Rd Ste 2021
San Rafael, CA 94903-4158

Other practice location 1

900 5th Ave
Suite 150
San Rafael, CA 94901-2959
Phone (415) 457-6966

Other practice location 2

20 N San Pedro Rd Ste 2021
San Rafael, CA 94903-4158
Phone (415) 305-8004

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

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1083810139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N SAN PEDRO RD STE 2021",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1682 NOVATO BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "94947",
            "telephone_number": "415-305-8004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 5th Ave",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949012959",
            "country_code": "US",
            "telephone_number": "415-457-6966",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 N San Pedro Rd Ste 2021",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949034158",
            "country_code": "US",
            "telephone_number": "415-305-8004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCANN",
        "first_name": "ELIZABETH",
        "middle_name": "GRACE",
        "name_prefix": "Miss",
        "credential": "APCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "5134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.