Myra Qualls Elder, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P0000002156 Issued in TN

Practice address

Psychology Service
116B2
Mountain Home, TN 37684-4000

Phone

(423) 926-1171

Fax

(423) 979-3447

NPI assigned

Sep 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184726416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4000",
            "address_2": "116B2",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376844000",
            "telephone_number": "423-926-1171",
            "fax_number": "423-979-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PSYCHOLOGY SERVICE",
            "address_2": "116B2",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376844000",
            "telephone_number": "423-926-1171",
            "fax_number": "423-979-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "MYRA",
        "middle_name": "QUALLS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000002156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary A. Dula, NURSE PRACTITIONER
• Allen R Dyer, M.D.
• William Albert Dykes Jr., D.D.S.
• Susan Elaine, M.ED., L.M.F.T.
• Tonia Bailey Elbers, P.T.
• Arthur Ray Ellis, PHD, MS
• Donna Marie Emmert, RD
• Chelsa Jean Ervin, LCSW
• Frank Barton Evans III, PH.D.
• Ladonna R Fair, LMSW

• Clinical Psychologist in Mountain Home, TN
• Providers in Mountain Home, TN by specialty
• Clinical Psychologist in Tennessee

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.