Individual provider Active NPI

Elizabeth A Freeze, LCSW

  • Clinical Social Worker
  • Benton, AR
National Provider Identifier
1437496718
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6542-C Issued in AR
Practice address
110 Pearson
Benton, AR 72015
Phone
(501) 315-4224
Fax
(501) 778-0450
NPI assigned
Jan 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6542-M AR
Clinical Social Worker 1041C0700X 6542-C AR Primary

Addresses

Primary practice location

110 Pearson
Benton, AR 72015

Mailing address

110 Pearson
Benton, AR 72015-4436
Phone (501) 315-4224

Other names 1

  • Elizabeth A Gatlin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20200408000597 AR Practitioner - Clinical Social Worker 6204265580 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6542-MARMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Clinic, Inc. CurrentSince Mar 23, 2020 Accepting new patients
Counseling Clinic, Inc Clinical CurrentSince Mar 23, 2020 Accepting new patients

Locations

110 Pearson
Benton, AR 72015
Phone (501) 315-4224

310 Whittington Ave
Hot Springs National Park, AR 71901
Phone (501) 623-3477

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1437496718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PEARSON",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154436",
            "telephone_number": "501-315-4224",
            "fax_number": "501-778-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PEARSON",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72015",
            "telephone_number": "501-315-4224",
            "fax_number": "501-778-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEZE",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "6542-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6542-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "GATLIN",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.