Individual provider Active NPI

Elizabeth Leppaluoto Holt, MFT

  • Marriage & Family Therapist
  • Lake Mary, FL
National Provider Identifier
1639696917
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3307 Issued in FL
Practice address
1054 Henley Downs PL
Lake Mary, FL 32746-1972
Phone
(407) 782-8833
NPI assigned
Aug 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3307 FL Primary

Addresses

Primary practice location

1054 Henley Downs PL
Lake Mary, FL 32746-1972

Mailing address

1054 Henley Downs PL
Lake Mary, FL 32746-1972
Phone (407) 782-8833

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
I20241121002704 FL Practitioner - Marriage and Family Therapist 3476088840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beth Davalos Counseling Center LLCGroup PAC ID 3375978414, 32 clinicians

Practice addresses (Care Compare)

540 E Horatio Ave
Suite 200
Maitland, FL 32751-7314
Phone (407) 401-9020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Davalos Counseling Center LLC CurrentSince Oct 7, 2024 Accepting new patients

Locations

540 E Horatio Ave
Ste 200
Maitland, FL 32751
Phone (407) 401-9020

Organizations & group practices 1

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": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639696917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 HENLEY DOWNS PL",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461972",
            "telephone_number": "407-782-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 HENLEY DOWNS PL",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461972",
            "telephone_number": "407-782-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "ELIZABETH",
        "middle_name": "LEPPALUOTO",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "3307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.