Individual provider Active NPI

Katybeth C Eller, LPCMHSP

  • Professional Counselor
  • Chattanooga, TN
National Provider Identifier
1245788009
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701008099 Issued in VA
Practice address
801 N Holtzclaw Ave
Suite 101
Chattanooga, TN 37404-1236
Phone
(423) 209-7091
Fax
(423) 209-7088
NPI assigned
Sep 21, 2016
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 3715 TN
Professional Counselor 101YP2500X 0701008099 VA Primary
Professional Counselor 101YP2500X 3715 TN

Addresses

Primary practice location

801 N Holtzclaw Ave
Suite 101
Chattanooga, TN 37404-1236

Mailing address

801 N Holtzclaw Ave
Suite 101
Chattanooga, TN 37404-1236
Phone (423) 209-7091

Other practice location 1

2300 Commonwealth Dr Ste 100
Charlottesville, VA 22901-1894
Phone (855) 284-7483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20231227001225 VA Practitioner - Mental Health Counselor 0749630192 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3715TNMDOptometrist

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": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1245788009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N HOLTZCLAW AVE",
            "address_2": "SUITE 101",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041236",
            "telephone_number": "423-209-7091",
            "fax_number": "423-209-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N HOLTZCLAW AVE",
            "address_2": "SUITE 101",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041236",
            "telephone_number": "423-209-7091",
            "fax_number": "423-209-7088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Commonwealth Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229011894",
            "country_code": "US",
            "telephone_number": "855-284-7483",
            "fax_number": "617-807-0958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLER",
        "first_name": "KATYBETH",
        "middle_name": "C",
        "credential": "LPCMHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "3715",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008099",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "3715",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.