Active NPI
Elizabeth K Heldt, PSS
- Clinical Social Worker
- Coos Bay, OR
National Provider Identifier
1891982492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801097271
- Practice address
- 377 Laclair Street
Coos Bay, OR 97420 - Phone
- (541) 756-2057
- Fax
- (541) 808-2231
- NPI assigned
- Sep 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801097271 | MI | Primary |
Addresses
Primary practice location
377 Laclair Street
Coos Bay, OR 97420
Mailing address
P.O. Box 1013
North Bend, OR 97459
Phone (541) 756-2057
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149-003854 | Other | IL | STATE LICENSE |
| 6801097271 | Other | MI | STATE LICENSE |
Other names 1
- Elizabeth K Petersen
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801097271 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711670400000",
"number": "1891982492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1013",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "97459",
"telephone_number": "541-756-2057",
"fax_number": "517-789-1286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "377 LACLAIR STREET",
"city": "COOS BAY",
"state": "OR",
"postal_code": "97420",
"telephone_number": "541-756-2057",
"fax_number": "541-808-2231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HELDT",
"first_name": "ELIZABETH",
"middle_name": "K",
"credential": "PSS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-27",
"last_updated": "2024-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801097271",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "149-003854",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "6801097271",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "PETERSEN",
"middle_name": "K",
"credential": "LMSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.