Individual provider Active NPI

Elizabeth Lee Ann Marcum, LCSW, LCDC

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1104535319
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
67460 Issued in TX
Practice address
3007 Longhorn Blvd
Austin, TX 78758-7636
Phone
(512) 566-4233
NPI assigned
Nov 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17118 TX
Clinical Social Worker 1041C0700X 67460 TX Primary

Addresses

Primary practice location

3007 Longhorn Blvd
Austin, TX 78758-7636

Mailing address

PO Box 530026
Harlingen, TX 78553-0026
Phone (956) 659-3553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
New York, NY 10087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17118TXMDAddiction (Substance Use Disorder) Counselor
67460TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dose Management PA Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: elizabeth.marcum.1@25634.direct.athenahealth.com

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": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1104535319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530026",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785530026",
            "telephone_number": "956-659-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 LONGHORN BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787587636",
            "telephone_number": "512-566-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUM",
        "first_name": "ELIZABETH",
        "middle_name": "LEE ANN",
        "credential": "LCSW, LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "17118",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "67460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.