Individual provider Active NPI

Elizabeth Ann Watson, MA, LCMHC-A

  • Professional Counselor
  • Raeford, NC
National Provider Identifier
1760014211
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A15493 Issued in NC
Practice address
121 E Elwood Ave
Raeford, NC 28376-2947
Phone
(910) 875-8156
NPI assigned
Feb 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A15493 NC Primary

Addresses

Primary practice location

121 E Elwood Ave
Raeford, NC 28376-2947

Mailing address

284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100

Other practice location 1

2525 Raeford Rd
Fayetteville, NC 28305-5091
Phone (910) 302-6689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240314000493 NC Practitioner - Mental Health Counselor 7517303407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Daymark Recovery Services IncGroup PAC ID 0547233975, 132 clinicians

Practice addresses (Care Compare)

121 E Elwood Ave
Raeford, NC 28376-2947
Phone (910) 875-8156

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A15493NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118

1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836

121 E Elwood Ave
Raeford, NC 28376
Phone (910) 875-8156

2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616

Interoperability endpoints

  • Direct secure messaging: elizabeth.watson.p1@direct.daymarkrecovery.nextgenshare.com

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": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1760014211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E ELWOOD AVE",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283762947",
            "telephone_number": "910-875-8156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Raeford Rd",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283055091",
            "country_code": "US",
            "telephone_number": "910-302-6689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MA, LCMHC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A15493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raeford, NC

Sources for this page

Verify at the official NPI Registry.