Elizabeth Anderson, R-DMT, RYT

Primary specialty

Dance TherapistTaxonomy code 225600000X

License

1564

Practice address

116 Patterson Rd
Hanscom Afb, MA 01731-2651

Phone

(850) 420-2399

NPI assigned

Jun 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1124687215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 PATTERSON RD",
            "city": "HANSCOM AFB",
            "state": "MA",
            "postal_code": "017312651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 PATTERSON RD",
            "city": "HANSCOM AFB",
            "state": "MA",
            "postal_code": "017312651",
            "telephone_number": "850-420-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ELIZABETH",
        "credential": "R-DMT, RYT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225600000X",
            "taxonomy_group": "",
            "desc": "Dance Therapist",
            "state": null,
            "license": "1564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 66TH Medsq-Hanscom
• 66TH Medsq-Hanscom
• Georgette Abboud, FNP-C
• Eric An, PHD
• Courtney J. Arrington, M.D.
• Jemma Ayvazian, N.P.
• Jennifer Dawn Bankston, WHNP
• Brayden Tyler Bennett, PHARM. D.
• Amy Bonneau, LICSW

• Dance Therapist in Hanscom Afb, MA
• Providers in Hanscom Afb, MA by specialty
• Dance Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.