Individual provider Active NPI

Elaine E Faunce, PH D

  • Psychologist
  • Salem, MA
National Provider Identifier
1043389695
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3509 Issued in MA
Practice address
30 Federal St
Ste 101
Salem, MA 07920-3801
Phone
(978) 744-8070
Fax
(089) 744-8070
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3509 MA Primary

Addresses

Primary practice location

30 Federal St
Ste 101
Salem, MA 07920-3801

Mailing address

30 Federal St
Ste 101
Salem, MA 07920-3801
Phone (978) 744-8070

Other identifiers 3

IdentifierTypeStateIssuer
W03541OtherMABC BS
1012860OtherFCH FALLON COM HLTH
459415000OtherMAGELLAN BCH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101021000398 MA Practitioner - Clinical Psychologist 0648463729 Practice locations: Salem, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Salem, MA 01970
Phone (978) 744-8070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3509MAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1043389695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 FEDERAL ST",
            "address_2": "STE 101",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "079203801",
            "telephone_number": "978-744-8070",
            "fax_number": "089-744-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 FEDERAL ST",
            "address_2": "STE 101",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "079203801",
            "telephone_number": "978-744-8070",
            "fax_number": "089-744-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUNCE",
        "first_name": "ELAINE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "3509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "W03541",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FCH FALLON COM HLTH",
            "identifier": "1012860",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BCH",
            "identifier": "459415000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.