Elizabeth Widtfeldt, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

76967 Issued in TX

Practice address

1935 Medical District Dr
Dallas, TX 75235-7701

Phone

(844) 856-6926

Fax

(214) 867-5383

NPI assigned

Feb 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Elizabeth Cretekos Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1306384342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "844-856-6926",
            "fax_number": "214-867-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "844-856-6926",
            "fax_number": "214-867-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDTFELDT",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-10",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC008981",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "76967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "CRETEKOS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Itala Manosha Wickremasinghe, MD
• Joyclyn T Wicks, M.D.
• Sarah Wicks, CAA
• Xaquita Wicks, FNP-C, MSN, BSN, RN
• Kristina Widjaja, PA-C
• Robert Arthur Wiebe, MD
• Jaime Lauren Wiebel, MD
• Linda M Wiede, WHCNP
• Michael Wiederkehr, M.D.
• Aaron Lee Wiegmann, MD

• Professional Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.