Individual provider Active NPI

Elizabeth Ann Todd, LIMHP, LCSW

  • Mental Health Counselor
  • Grand Island, NE
National Provider Identifier
1740764372
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2626 Issued in NE
Practice address
2608 Old Fair Rd
Grand Island, NE 68803-5271
Phone
(308) 382-5297
Fax
(308) 382-5315
NPI assigned
Sep 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11653 NE
Mental Health Counselor 101YM0800X 1912 NE
Mental Health Counselor 101YM0800X 2626 NE Primary

Addresses

Primary practice location

2608 Old Fair Rd
Grand Island, NE 68803-5271

Mailing address

2608 Old Fair Rd
Grand Island, NE 68803-5271
Phone (308) 382-5297

Other identifiers 1

IdentifierTypeStateIssuer
10025173100MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20200506002196 NE Practitioner - Clinical Social Worker 0244661221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wholeness Healing Center PCGroup PAC ID 3173571320, 13 clinicians

Practice addresses (Care Compare)

2608 Old Fair Rd
Grand Island, NE 68803-5271
Phone 3083825297211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11653NEMDPharmacist
1912NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wholeness Healing Center PC Mental Health CurrentSince Mar 26, 2020 Accepting new patients

Locations

2608 Old Fair Rd
Grand Island, NE 68803
Phone (308) 382-5297

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": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1740764372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 OLD FAIR RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035271",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 OLD FAIR RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688035271",
            "telephone_number": "308-382-5297",
            "fax_number": "308-382-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LIMHP, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "11653",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1912",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025173100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.