Elisabeth C Box, LMFT
Individual provider Active NPI Marriage & Family Therapist · Nipomo, CA
NPI 1700912466 · NPPES record last updated Aug 21, 2022
Key facts
- NPI
- 1700912466
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 119471 (CA)
- Practice address
- 1631 Kirby Way
Nipomo, CA 93444-9678 - Phone
- (805) 266-8001
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250502001112 | CA | Practitioner - Marriage and Family Therapist | 7810413879 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119471 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jonah'S House | Marriage & Family Therapist | Current |
Accepting new patients |
Locations
136 S Halcyon Rd
Arroyo Grande, CA 93420
Phone (805) 242-2102
110 S Mary Ave
Ste 2
Nipomo, CA 93444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 119471 | CA | Yes |
Addresses
Primary practice location
1631 Kirby Way
Nipomo, CA 93444-9678
Mailing address
110 S Mary Ave Ste 2
PMB 122
Nipomo, CA 93444-8750
Phone (805) 266-8001
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119471 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
Other providers in Nipomo, CA
- Tammy L Bonenfant
- Jennifer Bonino
- Kassandra Boortz
- Kenton Bosch
- Kari Marie Bowron
- Joni Kaye Brewer
- Kerren D Brown
- Brooks Burnsed
- Donald Edward Casebolt
- Riley Cash
All providers in Nipomo, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.