Elizabeth M Souffront, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7646 Issued in MA

Practice address

1400 Hancock St FL 2
Quincy, MA 02169-5233

Phone

(617) 774-0331

Fax

(617) 774-0336

NPI assigned

Jun 9, 2006

Last updated

Dec 1, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Clinical Psychologist

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Modern Assistance Programs, Inc.

  • Community/Behavioral Health Agency
  • Quincy, MA
  • NPI 1043765845
  Medicare reassignment NPD
• Arbour Elder Services, Inc.

  dba Arbour Senior Care

  • Community/Behavioral Health Agency
  • Rockland, MA
  • NPI 1417124181
  NPD (past)
• Nova Psychiatric Services, PC

  dba Prime Behavioral Health

  • Community/Behavioral Health Agency
  • Quincy, MA
  • NPI 1881782522
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1720029085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 PHIPPS ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021696625",
            "telephone_number": "617-479-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HANCOCK ST FL 2",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695233",
            "telephone_number": "617-774-0331",
            "fax_number": "617-774-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUFFRONT",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7646",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Raymond Somers Jr.
• Kevin K Song, DMD
• Kanika Sood, MD
• Judith Sorenti, LMHC
• Olushola H Sotunbo
• Soulcraft Psych LLC
• Shannon Sousa
• South Cove Community Health Center, Inc.
• South Cove Community Health Center, Inc.
• South Cove Manor Nursing and Rehabilitation Center, Inc. (South Cove Manor Nursing and Rehabilitation Center)

• Clinical Psychologist in Quincy, MA
• Providers in Quincy, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.