Individual provider Active NPI

Elizabeth Joan Kornkven, LPC

  • Mental Health Counselor
  • Casper, WY
National Provider Identifier
1730460932
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
411 S Walsh Dr
Casper, WY 82609-2306
Phone
(307) 336-3770
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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 Primary

Addresses

Primary practice location

411 S Walsh Dr
Casper, WY 82609-2306

Mailing address

5311 S David St
Casper, WY 82601-6339
Phone (307) 333-3060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20240320000086 WY Practitioner - Mental Health Counselor 4688011174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

411 S Walsh Dr
Casper, WY 82609-2306
Phone (307) 336-3770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Livingwater Counseling CurrentSince Jan 7, 2024 Accepting new patients

Locations

411 S Walsh Dr
Casper, WY 82609
Phone (307) 336-3770

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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1730460932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5311 S DAVID ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826016339",
            "telephone_number": "307-333-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S WALSH DR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826092306",
            "telephone_number": "307-336-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNKVEN",
        "first_name": "ELIZABETH",
        "middle_name": "JOAN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.