Individual provider Active NPI

Elaine Marilynn Swenson, M.A.,LLP

  • Psychologist
  • Beverly Hills, MI
National Provider Identifier
1124044037
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301001904 Issued in MI
Practice address
31000 Lahser Rd
Suite 8
Beverly Hills, MI 48025-4847
Phone
(248) 723-6626
Fax
(248) 723-9499
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301001904 MI Primary

Addresses

Primary practice location

31000 Lahser Rd
Suite 8
Beverly Hills, MI 48025-4847

Mailing address

31000 Lahser Rd
Suite 8
Beverly Hills, MI 48025-4847
Phone (248) 723-6626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131218001112 MI Practitioner - Psychologist Billing Independently 1355578626 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6301001904MIMDPsychologist

Organizations & group practices 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124044037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31000 LAHSER RD",
            "address_2": "SUITE 8",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480254847",
            "telephone_number": "248-723-6626",
            "fax_number": "248-723-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31000 LAHSER RD",
            "address_2": "SUITE 8",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480254847",
            "telephone_number": "248-723-6626",
            "fax_number": "248-723-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENSON",
        "first_name": "ELAINE",
        "middle_name": "MARILYNN",
        "name_prefix": "Ms.",
        "credential": "M.A.,LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301001904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.