MEDICARE: MICHAEL CODY ELLIOTT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	20251	TX

General Provider Information

NPI Number	:	1649338583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CODY ELLIOTT LPC

Provider Business Mailing Address
First Line	:	2235 COUNTY ROAD 3504
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-6187
Country	:	US
Telephone Number	:	903-243-6073
Fax Number	:

Provider Business Practice Location Address
First Line	:	2235 COUNTY ROAD 3504
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-6187
Country	:	US
Telephone Number	:	903-243-6073
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	12/12/2025

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Directions to “ MICHAEL CODY ELLIOTT LPC” Practice Location

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