Elizabeth Ann Smith, LPC, ATR

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178015418 Issued in IL

Practice address

200 S Frontage Rd Ste 320
Burr Ridge, IL 60527-6953

Phone

(630) 337-8006

NPI assigned

Jul 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Ann Vandermolen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Restoring Wellness Clinical Services, PLLC

  • Psychologist
  • Burr Ridge, IL
  • NPI 1457990343

  Mental Health

  NPD

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1104435478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S FRONTAGE RD STE 320",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276953",
            "telephone_number": "630-337-8006",
            "fax_number": "630-537-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S FRONTAGE RD STE 320",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276953",
            "telephone_number": "630-337-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPC, ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178015418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "VANDERMOLEN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ronda L Skilton, LCPC
• Nathan Skorodin, PHARMD
• John Peter Slauson, PTA
• Brittany Smith
• Christopher R Smith, DDS
• Kevin M Smith, MD
• Sheri Lynn Smith
• SMS Medical Inc
• SMSM Seniors Service LLC
• Sodipe and Associates, Inc

• Mental Health Counselor in Burr Ridge, IL
• Providers in Burr Ridge, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.