ELIZABETH A DOUGLAS MA, LADC, LPCC
NPI 1336439306
Counselor - Mental Health in Coon Rapids, MN

Q: What is Elizabeth Douglas's NPI number?

The NPI number for Elizabeth Douglas is 1336439306. It was assigned to this individual provider in the NPPES registry on April 12, 2011. The provider is also known as Elizabeth A Myhre Ba, Ladc.

Q: What is Elizabeth Douglas's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Elizabeth Douglas was last updated on October 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 12, 2011PECOS EnrolledAccepts Medicare Assignment

11660 ROUND LAKE BLVD NW, COON RAPIDS, MN 55433(763) 439-4984(763) 767-0912 Get Directions Write a Review

NPPES record last updated: October 23, 2023. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Oct 23, 2023, Feb 6, 2020 (2 updates tracked since 2020).

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About Elizabeth A Douglas Ma, Ladc, Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZABETH A DOUGLAS MA, LADC, LPCC (NPI 1336439306) is an individual mental health provider in Coon Rapids, Minnesota, licensed in Minnesota (2409) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1336439306

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameELIZABETH A DOUGLASCredential: MA, LADC, LPCC

Location Address11660 ROUND LAKE BLVD NWCoon Rapids, MN 55433-2638

Mailing Address11660 Round Lake Blvd NwCoon Rapids, MN 55433-2638 · (763) 439-4984 · Fax (763) 767-0912

Phone(763) 439-4984

Fax(763) 767-0912

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateApril 12, 2011

Last NPPES UpdateOctober 23, 20232 updates tracked since enumeration

NPPES CertifiedOctober 23, 2023

✔ NPI 1336439306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in MN · 2409

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 302188 (MN)

11660 ROUND LAKE BLVD NW, Coon Rapids, MN 55433

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Other Names 1

Former Name (1)Elizabeth A Myhre Ba, Ladc

Secondary Practice Locations 2

Location 12807 Brookdale DrBrooklyn Park, MN 55444-1844 · Phone (651) 200-6088

Location 23329 University Ave SEMinneapolis, MN 55414-3325 · Phone (612) 454-2281

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Elizabeth A Douglas Ma, Ladc, Lpcc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668822172

PECOS Enrollment IDI20231226001088

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RUTH EILTS

Social Worker (Clinical)