Individual provider Active NPI

Elizabeth Rose Whittaker, LMHC

  • Mental Health Counselor
  • Plymouth, MA
National Provider Identifier
1114192788
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11547-MH-CC Issued in MA
Practice address
103 Court St Ste C
Plymouth, MA 02360-8713
Phone
(508) 591-0593
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 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 11547-MH-CC MA Primary

Addresses

Primary practice location

103 Court St Ste C
Plymouth, MA 02360-8713

Mailing address

1 Sleepy Hollow Dr
Plymouth, MA 02360-3579
Phone (508) 591-0593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20241118000292 MA Practitioner - Mental Health Counselor 2062946791 Practice locations: Plymouth, MA

Care Compare profile

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

Practice addresses (Care Compare)

1 Sleepy Hollow Dr
Plymouth, MA 02360-3579

225 Water St
Suite A208
Plymouth, MA 02360-4078
Phone (508) 591-0593

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11547-MH-CCMAMDMental Health Counselor
11547MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1114192788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SLEEPY HOLLOW DR",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023603579",
            "telephone_number": "508-591-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 COURT ST STE C",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023608713",
            "telephone_number": "508-591-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "ELIZABETH",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "11547-MH-CC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.