Individual provider Active NPI

Elizabeth I Meyer, LCSW, LAC

  • Social Worker
  • Grand Forks, ND
National Provider Identifier
1770148371
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
5725 Issued in ND
Practice address
151 S 4TH St Ste 401
Grand Forks, ND 58201-4715
Phone
(701) 795-3000
Fax
(701) 795-3050
NPI assigned
May 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X 1854 ND
Social Worker 104100000X 5725 ND Primary

Addresses

Primary practice location

151 S 4TH St Ste 401
Grand Forks, ND 58201-4715

Mailing address

151 S 4TH St Ste 401
Grand Forks, ND 58201-4715
Phone (701) 795-3000

Other practice location 1

2520 S Washington St Unit C
Grand Forks, ND 58201-6777
Phone (970) 397-7929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20240519000028 ND Practitioner - Clinical Social Worker 9335580596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2520 S Washington St
Unit C
Grand Forks, ND 58201-6777
Phone (701) 213-0229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1854NDMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Blended Pathways Therapy, PLLC Addiction (Substance Use Disorder) CurrentSince Feb 24, 2024 Accepting new patients
Calming Waters Therapy PLLC PastSince Jan 15, 2024 Accepting new patients

Locations

2520 S Washington St
Unit C
Grand Forks, ND 58201
Phone (218) 280-1250

Organizations & group practices 2

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": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1770148371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 S 4TH ST STE 401",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014715",
            "telephone_number": "701-795-3000",
            "fax_number": "701-795-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S 4TH ST STE 401",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014715",
            "telephone_number": "701-795-3000",
            "fax_number": "701-795-3050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2520 S Washington St Unit C",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582016777",
            "country_code": "US",
            "telephone_number": "970-397-7929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYER",
        "first_name": "ELIZABETH",
        "middle_name": "I",
        "credential": "LCSW, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1854",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "5725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.