Susan Elaine, M.ED., L.M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

176 Issued in TN

Practice address

Lake Dr.
Building 52
Mountain Home, TN 37684

Phone

(423) 439-8000

Fax

(423) 439-2200

NPI assigned

Nov 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

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.

• Medical Education Assistance Corporation

  • Psychiatry Physician
  • Mountain Home, TN
  • NPI 1518236538

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1295801512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-8000",
            "fax_number": "423-439-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAKE DR.",
            "address_2": "BUILDING 52",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-439-8000",
            "fax_number": "423-439-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAINE",
        "first_name": "SUSAN",
        "credential": "M.ED., L.M.F.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "176",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nigel Dsouza, M.D.
• Lauren Dubose, PHARMD
• Gary A. Dula, NURSE PRACTITIONER
• Allen R Dyer, M.D.
• William Albert Dykes Jr., D.D.S.
• Tonia Bailey Elbers, P.T.
• Myra Qualls Elder, PH.D.
• Arthur Ray Ellis, PHD, MS
• Donna Marie Emmert, RD
• Chelsa Jean Ervin, LCSW

• Marriage & Family Therapist in Mountain Home, TN
• Providers in Mountain Home, TN by specialty
• Marriage & Family Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.