Individual provider Active NPI

Elizabeth Ann Edwards

  • Counselor
  • Edmond, OK
National Provider Identifier
1508135351
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2211 Issued in OK
Practice address
509 Wildmeadow Dr
Edmond, OK 73003-3031
Phone
(405) 216-9313
NPI assigned
Dec 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2211 OK Primary

Addresses

Primary practice location

509 Wildmeadow Dr
Edmond, OK 73003-3031

Mailing address

509 Wildmeadow Dr
Edmond, OK 73003-3031
Phone (405) 216-9313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20250612002338 OK Practitioner - Mental Health Counselor 0749791242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Therapy Solutions of Oklahoma, LLCGroup PAC ID 2264808211, 22 clinicians

Practice addresses (Care Compare)

620 NW 5TH St D
Main Office
Moore, OK 73160-3947
Phone (405) 208-4469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2211OKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Virginia, Inc. CurrentSince Aug 8, 2025 Accepting new patients
Integrated Therapy Solutions of Oklahoma, LLC CurrentSince Jun 1, 2025 Accepting new patients
Optum Behavioral Care of Virginia, Inc. CurrentSince Aug 8, 2025 Accepting new patients

Locations

620 NW 5th St
Ste D
Moore, OK 73160

9212 N Kelley Ave
#200
Oklahoma City, OK 73131
Phone (405) 242-5070

4801 Gaillardia Pkwy
Ste 200
Oklahoma City, OK 73142
Phone (405) 456-0101

Organizations & group practices 3

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": "1324598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1508135351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 WILDMEADOW DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730033031",
            "telephone_number": "405-216-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 WILDMEADOW DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730033031",
            "telephone_number": "405-216-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-23",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "2211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.