Individual provider Active NPI

Elena 'Elle' Hazlewood, SUDPT

  • Counselor
  • Longview, WA
National Provider Identifier
1982384624
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
61419838 Issued in WA
Practice address
910 16TH Ave Ste 120
Longview, WA 98632-2374
Phone
(360) 200-5419
Fax
(360) 200-6736
NPI assigned
Jul 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 61419838 WA Primary

Addresses

Primary practice location

910 16TH Ave Ste 120
Longview, WA 98632-2374

Mailing address

PO Box 2394
Longview, WA 98632-8455
Phone (360) 200-5419

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

LicenseStateTypeSpecialty
61419838WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Core Health CurrentSince Jul 23, 2023 Accepting new patients

Locations

1400 Commerce Ave
Longview, WA 98632
Phone (360) 200-5419

910 16th Ave
Ste 120
Longview, WA 98632
Phone (360) 200-5419

Organizations & group practices 1

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": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1982384624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2394",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328455",
            "telephone_number": "360-200-5419",
            "fax_number": "360-200-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 16TH AVE STE 120",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322374",
            "telephone_number": "360-200-5419",
            "fax_number": "360-200-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZLEWOOD",
        "first_name": "ELENA 'ELLE'",
        "credential": "SUDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "61419838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.