Individual provider Active NPI

Elizabeth A Boston, LPCC

  • Professional Counselor
  • Monticello, KY
National Provider Identifier
1710375803
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1173 Issued in KY
Practice address
278 Kenny Davis Blvd
Monticello, KY 42633-9479
Phone
(844) 435-0900
Fax
(270) 858-4029
NPI assigned
Dec 26, 2014
Last updated
Jul 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1173 KY Primary

Addresses

Primary practice location

278 Kenny Davis Blvd
Monticello, KY 42633-9479

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other identifiers 2

IdentifierTypeStateIssuer
12784689OtherKYCAQH
7100322070MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20231130000438 KY Practitioner - Mental Health Counselor 4587012679 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1173KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Cumberland Family Medical Center Inc Current Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Lake Cumberland Regional Mental Health Mental Retardation Board, Inc. Past Accepting new patients
Cumberland Family Medical Center Inc Past Accepting new patients
Rise Mental Health and Wellness PastSince Mar 21, 2024 Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

322 General John Adair Dr
Columbia, KY 42728
Phone (270) 384-5308

526 Indian Dr
Columbia, KY 42728
Phone (270) 384-6515

870 Indian Dr
Columbia, KY 42728
Phone (270) 384-0077

1841 E Ky 70
Liberty, KY 42539
Phone (606) 787-6151

2834 S US 127
Liberty, KY 42539
Phone (606) 787-6941

6295 E Ky 70
Liberty, KY 42539
Phone (606) 787-1217

75 College St
Liberty, KY 42539
Phone (606) 787-6961

1080 S Main St
Monticello, KY 42633

160 Cave St
Monticello, KY 42633

2 Kenny Davis Blvd
Monticello, KY 42633
Phone (606) 378-5575

278 Kenny Davis Blvd
Monticello, KY 42633

95 Champion Dr
Monticello, KY 42633
Phone (606) 348-6691

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1419552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1710375803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 KENNY DAVIS BLVD",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "426339479",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-26",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "1173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12784689",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100322070",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, KY

Sources for this page

Verify at the official NPI Registry.