Individual provider Active NPI

Elizabeth Thorn, LPC-MH LMFT

  • Mental Health Counselor
  • Rapid City, SD
National Provider Identifier
1679514244
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-MH2097 Issued in SD
Practice address
1301 West Omaha St
Suite 220
Rapid City, SD 57701
Phone
(605) 716-9944
Fax
(605) 718-0413
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC-MH2097 SD
Professional Counselor 101YP2500X LPC-MH2097 SD
Marriage & Family Therapist 106H00000X LMFT1072 SD
Mental Health Counselor 101YM0800X LPC-MH2097 SD Primary

Addresses

Primary practice location

1301 West Omaha St
Suite 220
Rapid City, SD 57701

Mailing address

1301 West Omaha St
Suite 220
Rapid City, SD 57701
Phone (605) 716-9944

Other identifiers 1

IdentifierTypeStateIssuer
6575740MedicaidSD

Other names 1

  • Liz Jetson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 28, 2025 through Jan 28, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC-MH2097SDMDMental Health Counselor
LMFT1072SDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thorn-Jetson Corporation PastSince Jul 20, 2021 Accepting new patients

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1679514244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 WEST OMAHA ST",
            "address_2": "SUITE 220",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-716-9944",
            "fax_number": "605-718-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 WEST OMAHA ST",
            "address_2": "SUITE 220",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-716-9944",
            "fax_number": "605-718-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORN",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LPC-MH  LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SD",
            "license": "LPC-MH2097",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SD",
            "license": "LPC-MH2097",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "SD",
            "license": "LMFT1072",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "LPC-MH2097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6575740",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIZ",
            "last_name": "JETSON",
            "credential": "LPC-MH  LMFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.