Active NPI
Elizabeth Faye Flack, LCAS, LPA
- Addiction (Substance Use Disorder) Psychologist
- Wilmington, NC
National Provider Identifier
1902055528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Psychologist
- License
- LCAS-1932
- Practice address
- 1920 Tradd CT
Wilmington, NC 28401-6637 - Phone
- (910) 343-6890
- Fax
- (910) 332-1233
- NPI assigned
- Sep 18, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3599 | NC | |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | LCAS-1932 | NC | Primary |
Addresses
Primary practice location
1920 Tradd CT
Wilmington, NC 28401-6637
Mailing address
1920 Tradd CT
Wilmington, NC 28401-6637
Phone (910) 343-6890
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3599 | NC | MD | Professional Counselor |
| LCAS-1932 | NC | MD | Addiction (Substance Use Disorder) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607472000000",
"number": "1902055528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1920 TRADD CT",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284016637",
"telephone_number": "910-343-6890",
"fax_number": "910-332-1233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 TRADD CT",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284016637",
"telephone_number": "910-343-6890",
"fax_number": "910-332-1233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLACK",
"first_name": "ELIZABETH",
"middle_name": "FAYE",
"credential": "LCAS, LPA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-18",
"last_updated": "2020-12-09",
"certification_date": "2020-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "3599",
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-1932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
- Jean Mary Fitzgibbons
- Easton Victoria Fitzpatrick
- Cynthia R Fitzsimmons, PSY.D.
- Five Star Rehabilitation and Wellness Services, LLC (Ageility Physical Therapy Solutions at Wilmington)
- Fix N' 2 Talk
- Lorie Flanagan, AUD
- Carol Ann Flaugher, W.H.N.P.
- Skylar Alene Fleak
- Tyler Fleisher, DC
- Margaret Virginia Fleishman, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.