Elizabeth Terrill, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0171081 Issued in NM

Practice address

213 W Mesa Ave
Gallup, NM 87301-6335

Phone

(505) 862-9776

NPI assigned

Mar 23, 2010

Last updated

Apr 3, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gallup Child and Family Counseling

  • Professional Counselor
  • Gallup, NM
  • NPI 1043601313
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1790009553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 W MESA AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873016335",
            "telephone_number": "505-862-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W MESA AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873016335",
            "telephone_number": "505-862-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRILL",
        "first_name": "ELIZABETH",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-23",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0171081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67224857",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07322534",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Gallup, NM
• Providers in Gallup, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.