Individual provider Active NPI

Elizabeth Ann Williams, LCMHC

  • Mental Health Counselor
  • Fayetteville, NC
National Provider Identifier
1093060816
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13304 Issued in NC
Practice address
806 Hay St
Fayetteville, NC 28305-5312
Phone
(910) 860-7008
Fax
(910) 221-9006
NPI assigned
Jul 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A8829 NC
Mental Health Counselor 101YM0800X 13304 NC Primary

Addresses

Primary practice location

806 Hay St
Fayetteville, NC 28305-5312

Mailing address

806 Hay St
Fayetteville, NC 28305-5312
Phone (910) 860-7008

Other practice location 1

131 W Edinborough Ave
Raeford, NC 28376-2861
Phone (910) 848-1222

Other practice location 2

3507 Hill St
Hope Mills, NC 28348-1870
Phone (910) 339-0901

Other names 1

  • Elizabeth Ann Kruse Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240123001761 NC Practitioner - Mental Health Counselor 2860844156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

806 Hay St
Fayetteville, NC 28305-5312
Phone (910) 860-7008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13304NCMDMental Health Counselor
A8829NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Haymount Institute for Psychological Services, PLLC Mental Health CurrentSince Jan 12, 2024 Accepting new patients
Haymount Institute for Psychological Services, PLLC Mental Health CurrentSince Jan 12, 2024 Accepting new patients

Locations

806 Hay St
Fayetteville, NC 28305
Phone 9108607008117

3507 Hill St
Hope Mills, NC 28348
Phone (910) 339-0901

131 W Edinborough Ave
Raeford, NC 28376
Phone (910) 848-1222

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.

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093060816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 HAY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055312",
            "telephone_number": "910-860-7008",
            "fax_number": "910-221-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 HAY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055312",
            "telephone_number": "910-860-7008",
            "fax_number": "910-221-9006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 W Edinborough Ave",
            "address_purpose": "LOCATION",
            "city": "Raeford",
            "state": "NC",
            "postal_code": "283762861",
            "country_code": "US",
            "telephone_number": "910-848-1222",
            "fax_number": "910-848-0222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3507 Hill St",
            "address_purpose": "LOCATION",
            "city": "Hope Mills",
            "state": "NC",
            "postal_code": "283481870",
            "country_code": "US",
            "telephone_number": "910-339-0901",
            "fax_number": "910-339-0904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A8829",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "KRUSE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.