Individual provider Active NPI

Elizabeth R. Harris, LCMHC

  • Mental Health Counselor
  • Brattleboro, VT
National Provider Identifier
1629589056
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
068.0103817 Issued in VT
Practice address
167 Main St Ste 409
Brattleboro, VT 05301-3111
Phone
(802) 490-7550
NPI assigned
Oct 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 068.0103817 VT Primary

Addresses

Primary practice location

167 Main St Ste 409
Brattleboro, VT 05301-3111

Mailing address

390 River St
Springfield, VT 05156-2226
Phone (802) 886-4567

Other practice location 1

51 Fairview Street
Brattleboro, VT 05301
Phone (802) 254-6028

Other names 1

  • Elizabeth R Marshall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20240815003639 VT Practitioner - Mental Health Counselor 5890233258 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
068.0103817VTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care and Rehabilitation Services of Southeastern Vermont, Inc. CurrentSince Jun 8, 2024 Accepting new patients
Health Care and Rehabilitation Services of Southeastern Vermont, Inc. CurrentSince Jun 8, 2024 Accepting new patients

Locations

51 Fairview St
Brattleboro, VT 05301
Phone (802) 254-6028

390 River St
Springfield, VT 05156
Phone (802) 886-4567

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": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1629589056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 RIVER ST",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051562226",
            "telephone_number": "802-886-4567",
            "fax_number": "802-886-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MAIN ST STE 409",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053013111",
            "telephone_number": "802-490-7550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 Fairview Street",
            "address_purpose": "LOCATION",
            "city": "Brattleboro",
            "state": "VT",
            "postal_code": "05301",
            "country_code": "US",
            "telephone_number": "802-254-6028",
            "fax_number": "802-254-7501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ELIZABETH",
        "middle_name": "R.",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0103817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MARSHALL",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.