Individual provider Active NPI

Elizabeth Anne York, LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Bloomington, IN
National Provider Identifier
1730213232
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
34002826A Issued in IN
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

Updated by the provider on May 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
34002826AINMDAddiction (Substance Use Disorder) Counselor
39000882AINMDMental 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.

Verify at the official NPI Registry.