Elisa Roth, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1691 Issued in IA

Practice address

1225 S Gear Ave
West Burlington, IA 52655-1691

Phone

(319) 850-3443

NPI assigned

Apr 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Elisa Powell Professional name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Iowa Regional Medical Center IncGroup PAC ID 3870496417, 259 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Iowa Regional Medical Center Hospital, West Burlington, IA, CCN 160057

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southeast Iowa Regional Medical Center, Inc.

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southeast Iowa Regional Medical Center, Inc.

  • General Acute Care Hospital
  • West Burlington, IA
  • NPI 1134168263
  Care Compare affiliation

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1629464102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 S GEAR AVE",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551691",
            "telephone_number": "319-850-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S GEAR AVE",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551691",
            "telephone_number": "319-850-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "ELISA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "1691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "elisa.powell@direct.greatriverhealth.org",
            "affiliation": "N",
            "endpointDescription": "Great River Health Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1225 S Gear Ave",
            "city": "West Burlington",
            "state": "IA",
            "country_code": "US",
            "postal_code": "526551691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "elisa.powell@direct.greatriverhealth.org",
            "affiliation": "N",
            "endpointDescription": "Great River Health Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1225 S Gear Ave",
            "city": "West Burlington",
            "state": "IA",
            "country_code": "US",
            "postal_code": "526551691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELISA",
            "last_name": "POWELL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• River Cities Ophthalmology, P.C.
• Dominique Marie Antoine Robert Sapiain, DDS
• Jeffery Cole Roberts, FNP-C
• Thomas E Robertson, DPT
• Dawn Marie Rohrer, CNM
• Rushmore Pain and Medicine Inc
• Moldovan Sabov, MD
• Kelly Renee Samberg, ARNP
• Francis Madrinan Sanchez, M.D.
• Amanda Sant Amour, DDS

• Mental Health Counselor in West Burlington, IA
• Providers in West Burlington, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.