Javier Elizalde, NCAC II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

6020 Dawson Blvd Ste I
Norcross, GA 30093-1259

Phone

(770) 662-0249

Fax

(770) 449-5023

NPI assigned

Apr 8, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Clinic for Education, Treatment and Prevention of Addiction, Inc.

  • Community/Behavioral Health Agency
  • Norcross, GA
  • NPI 1396885059
  NPD (past)

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1932372216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 DAWSON BLVD STE I",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931259",
            "telephone_number": "770-662-0249",
            "fax_number": "770-449-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 DAWSON BLVD STE I",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931259",
            "telephone_number": "770-662-0249",
            "fax_number": "770-449-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZALDE",
        "first_name": "JAVIER",
        "name_prefix": "Mr.",
        "credential": "NCAC II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M Eifert, CNIM, R. EEG T.
• Elina Health Management LLC (Peachtree Urgent Care and Family Practice)
• Elina Healthcare Inc (Gwinnett Urgent Care & Family Practice)
• Elina Labs LLC
• Elite Medical Associates LLC
• Willette Ellerbe
• Ann Elliott
• Sean Ellis
• Elpis Hospice
• Embraced Soles & Medical DME LLC

• Addiction (Substance Use Disorder) Counselor in Norcross, GA
• Providers in Norcross, GA by specialty
• Addiction (Substance Use Disorder) Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.