Active NPI
Elizabeth Anne York, LCSW
- Addiction (Substance Use Disorder) Counselor
- Bloomington, IN
National Provider Identifier
1730213232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 34002826A
- Practice address
- 205 S Walnut St Ste 21
Bloomington, IN 47404-6137 - Phone
- (812) 322-2788
- Fax
- (866) 758-9013
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39000882A | IN | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 34002826A | IN | Primary |
Addresses
Primary practice location
205 S Walnut St Ste 21
Bloomington, IN 47404-6137
Mailing address
205 S Walnut St Ste 21
Bloomington, IN 47404-6137
Phone (812) 322-2788
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34002826A | IN | MD | Addiction (Substance Use Disorder) Counselor |
| 39000882A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1730213232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 S WALNUT ST STE 21",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474046137",
"telephone_number": "812-322-2788",
"fax_number": "866-758-9013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 S WALNUT ST STE 21",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474046137",
"telephone_number": "812-322-2788",
"fax_number": "866-758-9013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YORK",
"first_name": "ELIZABETH",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39000882A",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IN",
"license": "34002826A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.