Individual provider Active NPI

Suzann Marie Doran, LMFT, MAC

  • Marriage & Family Therapist
  • Auburn, IN
National Provider Identifier
1164695136
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
28109516A Issued in IN
Practice address
1800 Wesley Rd
Auburn, IN 46706-3653
Phone
(260) 925-2453
Fax
(260) 925-0830
NPI assigned
Apr 10, 2008
Last updated
Apr 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 28109516A IN Primary

Addresses

Primary practice location

1800 Wesley Rd
Auburn, IN 46706-3653

Mailing address

220 S Main St
PO Box 817
Kendallville, IN 46755-1718
Phone (260) 347-2453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240126003226 IN Practitioner - Marriage and Family Therapist 0345479507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Center IncGroup PAC ID 6709795636, 24 clinicians

Practice addresses (Care Compare)

1800 Wesley Rd
Auburn, IN 46706-3653
Phone (260) 925-2453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28109516AINMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Center, Inc CurrentSince Jan 1, 2024 Accepting new patients
Northeastern Center Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1800 Wesley Rd
Auburn, IN 46706
Phone (260) 925-2453

220 S Main St
Kendallville, IN 46755
Phone (219) 347-4400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1164695136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S MAIN ST",
            "address_2": "PO BOX 817",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467551718",
            "telephone_number": "260-347-2453",
            "fax_number": "260-347-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 WESLEY RD",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467063653",
            "telephone_number": "260-925-2453",
            "fax_number": "260-925-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAN",
        "first_name": "SUZANN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMFT, MAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "28109516A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, IN

Sources for this page

Verify at the official NPI Registry.