Suzanne Champagne Eusebio, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

000979 Issued in CT

Practice address

166 Center St Ste 100
Cape Canaveral, FL 32920-3740

Phone

(860) 460-5542

NPI assigned

Nov 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Marriage and Family Therapist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1184702300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 CENTER ST STE 100",
            "city": "CAPE CANAVERAL",
            "state": "FL",
            "postal_code": "329203740",
            "telephone_number": "860-460-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 CENTER ST STE 100",
            "city": "CAPE CANAVERAL",
            "state": "FL",
            "postal_code": "329203740",
            "telephone_number": "860-460-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPAGNE EUSEBIO",
        "first_name": "SUZANNE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "000979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "169428221850",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "410000979CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOHEGAN SUN, VALUEOPTIONS",
            "identifier": "574048",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Blizzard
• Mark Bolton
• Amanda L Booth, RN
• Cathbuddy Inc.
• Douglas Joseph Chadbourne, MD
• Suzanne M Clous, DPM
• Juliah Collins, IDHS
• Homi S Cooper, M.D.
• Daisys Delightful Companions LLC
• Scott J Dalton

• Marriage & Family Therapist in Cape Canaveral, FL
• Providers in Cape Canaveral, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.