Individual provider Active NPI

Elizabeth Stevenson

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1508570292
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW9241 Issued in FL
Practice address
12550 New Brittany Blvd Ste 100
Fort Myers, FL 33907-3655
Phone
(239) 343-9180
Fax
(239) 343-9188
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9241 FL
Mental Health Counselor 101YM0800X SW9241 FL Primary

Addresses

Primary practice location

12550 New Brittany Blvd Ste 100
Fort Myers, FL 33907-3655

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9180

Other practice location 1

1039 Bayshore Ave
Fort Myers, FL 33919-2605
Phone (407) 616-4471

Other identifiers 1

IdentifierTypeStateIssuer
125186500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230208003178 FL Practitioner - Clinical Social Worker 1355713801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

12550 New Brittany Blvd
Suite 100
Fort Myers, FL 33907-3655
Phone (239) 343-9180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW9241FLMDMental Health Counselor
9241FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Feb 27, 2023 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Feb 27, 2023 Accepting new patients
Lee Memorial Health System Current Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

12550 New Brittany Blvd
Ste 100
Fort Myers, FL 33907
Phone (239) 343-9180

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1508570292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9180",
            "fax_number": "239-343-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 NEW BRITTANY BLVD STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073655",
            "telephone_number": "239-343-9180",
            "fax_number": "239-343-9188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1039 Bayshore Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339192605",
            "country_code": "US",
            "telephone_number": "407-616-4471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "9241",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW9241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125186500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.