Individual provider Active NPI

Elizabeth A. Lewis, LCSW, RN

  • Mental Health Counselor
  • Woodstock, NY
National Provider Identifier
1356420749
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
046718-1 Issued in NY
Practice address
5 Playhouse LN
Woodstock, NY 12498-1609
Phone
(845) 679-9200
Fax
(845) 679-4360
NPI assigned
Nov 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 046718-1 NY Primary

Addresses

Primary practice location

5 Playhouse LN
Woodstock, NY 12498-1609

Mailing address

305 Chestnut Hill Rd
Woodstock, NY 12498-2421
Phone (845) 679-4200

Other identifiers 1

IdentifierTypeStateIssuer
02314574MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051228000276 NY Practitioner - Clinical Social Worker 6406878933 Practice locations: Woodstock, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

305 Chestnut Hill Rd
Woodstock, NY 12498-2421
Phone (845) 679-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
046718-1NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356420749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 CHESTNUT HILL RD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124982421",
            "telephone_number": "845-679-4200",
            "fax_number": "845-679-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PLAYHOUSE LN",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124981609",
            "telephone_number": "845-679-9200",
            "fax_number": "845-679-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ELIZABETH",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LCSW, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "046718-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02314574",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, NY

Sources for this page

Verify at the official NPI Registry.