Provider Demographics
NPI:1740764372
Name:TODD, ELIZABETH ANN (LIMHP, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:TODD
Suffix:
Gender:F
Credentials:LIMHP, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 OLD FAIR RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-5271
Mailing Address - Country:US
Mailing Address - Phone:308-382-5297
Mailing Address - Fax:308-382-5315
Practice Address - Street 1:2608 OLD FAIR RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-5271
Practice Address - Country:US
Practice Address - Phone:308-382-5297
Practice Address - Fax:308-382-5315
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11653101YM0800X
NE1912101YM0800X
NE2626101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025173100Medicaid