Individual provider Active NPI

Elizabeth Wiley Kovacs, LCSW

  • Clinical Social Worker
  • Cornelius, NC
National Provider Identifier
1356672851
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008400 Issued in NC
Practice address
18139 W Catawba Ave Ste 2
Cornelius, NC 28031-5641
Phone
(704) 966-9277
Fax
(980) 217-8402
NPI assigned
Jan 22, 2010
Last updated
Oct 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C008400 NC Primary

Addresses

Primary practice location

18139 W Catawba Ave Ste 2
Cornelius, NC 28031-5641

Mailing address

PO Box 435
Davidson, NC 28036-0435
Phone (704) 966-9277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20130829000817 NC Practitioner - Clinical Social Worker 8022251636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18139 W Catawba Ave
Suite 2
Cornelius, NC 28031-5641
Phone (704) 966-9277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clearwater Counseling and Consulting PLLC Clinical CurrentSince Oct 1, 2019 Accepting new patients
Lake Norman Family Therapy, PLLC Clinical PastSince Apr 9, 2020 Accepting new patients

Locations

18139 W Catawba Ave
Ste 2
Cornelius, NC 28031
Phone (704) 966-9277

Organizations & group practices 2

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": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1356672851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 435",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280360435",
            "telephone_number": "704-966-9277",
            "fax_number": "980-217-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18139 W CATAWBA AVE STE 2",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315641",
            "telephone_number": "704-966-9277",
            "fax_number": "980-217-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACS",
        "first_name": "ELIZABETH",
        "middle_name": "WILEY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

Verify at the official NPI Registry.