Individual provider Active NPI

Elizabeth Mae Wagner, MA, NCC

  • Counselor
  • Littleton, CO
National Provider Identifier
1083949945
Registry record updated Oct 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
5984 S Prince St Ste 101
Littleton, CO 80120-2083
Phone
(303) 738-1021
NPI assigned
Oct 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

5984 S Prince St Ste 101
Littleton, CO 80120-2083

Mailing address

4385 S Balsam St Unit 7-201
Denver, CO 80123-4603
Phone (303) 895-7204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240604000355 CO Practitioner - Mental Health Counselor 8224570445 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

Practice addresses (Care Compare)

12211 W Alameda Pkwy
Suite 105
Lakewood, CO 80228-2825
Phone (720) 722-4195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Green Mountain Counseling LLC CurrentSince Jun 9, 2024 Accepting new patients

Locations

12211 W Alameda Pkwy
Ste 105
Lakewood, CO 80228
Phone (720) 722-4195

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255305600000",
    "number": "1083949945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4385 S BALSAM ST UNIT 7-201",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "801234603",
            "telephone_number": "303-895-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5984 S PRINCE ST STE 101",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801202083",
            "telephone_number": "303-738-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ELIZABETH",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "MA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2009-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.