Active NPI
Elizabeth A Durham, M.A.
- Psychologist
- Hurricane, WV
National Provider Identifier
1831218999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 791
- Practice address
- 3983 Teays Valley Rd
Mt. Vernon Plaza Suite 101
Hurricane, WV 25526-8863 - Phone
- (304) 757-7800
- NPI assigned
- Mar 28, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 791 | WV | Primary |
Addresses
Primary practice location
3983 Teays Valley Rd
Mt. Vernon Plaza Suite 101
Hurricane, WV 25526-8863
Mailing address
PO Box 11928
Charleston, WV 25339-1928
Phone (304) 757-7800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 791 | WV | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831218999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11928",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253391928",
"telephone_number": "304-757-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3983 TEAYS VALLEY RD",
"address_2": "MT. VERNON PLAZA SUITE 101",
"city": "HURRICANE",
"state": "WV",
"postal_code": "255268863",
"telephone_number": "304-757-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURHAM",
"first_name": "ELIZABETH",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WV",
"license": "791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hurricane, WV
Sources for this page
- 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.