Individual provider Active NPI

Elizabeth A Wilson, LMHC

  • Mental Health Counselor
  • Watertown, NY
National Provider Identifier
1679809164
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
004198 Issued in NY
Practice address
650 State St
Watertown, NY 13601-2839
Phone
(315) 755-1251
Fax
(315) 291-6601
NPI assigned
Oct 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 004198 NY Primary

Addresses

Primary practice location

650 State St
Watertown, NY 13601-2839

Mailing address

120 Washington St Ste 312
Watertown, NY 13601-3330
Phone (315) 755-2665

Other practice location 1

120 Washington St Ste 312
Watertown, NY 13601-3330
Phone (315) 755-2665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20251125002468 NY Practitioner - Mental Health Counselor 2860984085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizen Advocates, IncGroup PAC ID 0648241976, 50 clinicians

Practice addresses (Care Compare)

650 State St
Watertown, NY 13601-2839
Phone (315) 755-1251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Citizen Advocates, Inc CurrentSince Nov 17, 2025 Accepting new patients

Locations

15 Francis St
Malone, NY 12953
Phone (518) 483-7801

650 State St
Watertown, NY 13601
Phone (315) 755-1251

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": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1679809164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WASHINGTON ST STE 312",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013330",
            "telephone_number": "315-755-2665",
            "fax_number": "315-755-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012839",
            "telephone_number": "315-755-1251",
            "fax_number": "315-291-6601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Washington St Ste 312",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136013330",
            "country_code": "US",
            "telephone_number": "315-755-2665",
            "fax_number": "315-755-2660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.