Individual provider Active NPI

Elizabeth K Stoothoff, LCPC-C

  • Mental Health Counselor
  • Saco, ME
National Provider Identifier
1750080735
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
XL6998 Issued in ME
Practice address
110 Main St
Saco, ME 04072-3509
Phone
(207) 200-7105
NPI assigned
Feb 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 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 XL6998 ME Primary

Addresses

Primary practice location

110 Main St
Saco, ME 04072-3509

Mailing address

46 Oak Ridge Dr
Standish, ME 04084-6048
Phone (207) 671-1285

Other identifiers 1

IdentifierTypeStateIssuer
012819671994MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20241120001001 ME Practitioner - Mental Health Counselor 6507391166 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
XL6998MEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Health Affiliates Maine, LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

306 Rodman Rd
Auburn, ME 04210
Phone (207) 333-3278

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": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1750080735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 OAK RIDGE DR",
            "city": "STANDISH",
            "state": "ME",
            "postal_code": "040846048",
            "telephone_number": "207-671-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN ST",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040723509",
            "telephone_number": "207-200-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOOTHOFF",
        "first_name": "ELIZABETH",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "LCPC-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL6998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012819671994",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saco, ME

Sources for this page

Verify at the official NPI Registry.