Active NPI
Elizabeth Bryant
- Professional Counselor
- Frederick, MD
National Provider Identifier
1417360439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC4399
- Practice address
- 4540 Mack Ave Ste B
Frederick, MD 21703-3303 - Phone
- (301) 733-0330
- Fax
- (301) 733-4038
- NPI assigned
- Jun 6, 2014
- Sex
- Female
- Sole proprietor
- No
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 | LC4399 | MD | Primary |
Addresses
Primary practice location
4540 Mack Ave Ste B
Frederick, MD 21703-3303
Mailing address
13218 Brooklane Dr
Hagerstown, MD 21742-1435
Phone (301) 733-0331
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 |
|---|---|---|---|
| LC4399 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409702400000",
"number": "1417360439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13218 BROOKLANE DR",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217421435",
"telephone_number": "301-733-0331",
"fax_number": "301-733-4038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4540 MACK AVE STE B",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217033303",
"telephone_number": "301-733-0330",
"fax_number": "301-733-4038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-06",
"last_updated": "2014-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC4399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.