Active NPI
Elizabeth Mathes
- Professional Counselor
- Coeur D Alene, ID
National Provider Identifier
1215055868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LCPC 200
- Practice address
- 118 N 7TH St Ste C4
Coeur D Alene, ID 83814-2736 - Phone
- (208) 676-8884
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LCPC 200 | ID | Primary |
Addresses
Primary practice location
118 N 7TH St Ste C4
Coeur D Alene, ID 83814-2736
Mailing address
1006 E Lakeside Ave
Coeur D Alene, ID 83814-4137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q4590 | Other | ID | BLUE CROSS OF IDAHO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC 200 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1215055868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 E LAKESIDE AVE",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838144137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 N 7TH ST STE C4",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142736",
"telephone_number": "208-676-8884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHES",
"first_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LCPC 200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "Q4590",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.