Individual provider Active NPI

Elizabeth Nicole Dyson, BSW

  • Social Worker
  • Wabash, IN
National Provider Identifier
1144655580
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3563 S State Road 13
Wabash, IN 46992-9162
Phone
(260) 563-8453
Fax
(260) 569-0335
NPI assigned
Sep 4, 2013
Last updated
Sep 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU Primary

Addresses

Primary practice location

3563 S State Road 13
Wabash, IN 46992-9162

Mailing address

3563 S State Road 13
Wabash, IN 46992-9162
Phone (260) 563-8453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20221116000154 IN Practitioner - Clinical Social Worker 2062880461 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Friends Counseling Center, Inc CurrentSince Aug 25, 2022 Accepting new patients

Locations

3565 S State Road 13
Wabash, IN 46992

3565 S State Road 13
#C
Wabash, IN 46992

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1144655580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3563 S STATE ROAD 13",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469929162",
            "telephone_number": "260-563-8453",
            "fax_number": "260-569-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3563 S STATE ROAD 13",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469929162",
            "telephone_number": "260-563-8453",
            "fax_number": "260-569-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYSON",
        "first_name": "ELIZABETH",
        "middle_name": "NICOLE",
        "credential": "BSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wabash, IN

Sources for this page

Verify at the official NPI Registry.