Mary Elder, AMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

121455 Issued in CA

Practice address

505 Lemon St
Redlands, CA 92374-5311

Phone

(909) 735-7818

NPI assigned

Jul 21, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Serene Pathways Family Counseling Inc

  • Marriage & Family Therapist
  • Chino, CA
  • NPI 1174913321
  NPD (past)

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831824929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7193",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923750193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 LEMON ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923745311",
            "telephone_number": "909-735-7818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11800 Central Ave Ste 225",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917107201",
            "country_code": "US",
            "telephone_number": "909-576-3889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELDER",
        "first_name": "MARY",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "121455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Olufunmilola Ekong, CNS
• Ufan James Ekpo
• Raed El Hajjaoui, M.D.
• Mohamed El-Laham, DDS
• Rabeah Elbanna, RPH
• Graham Kendrick Eleazar
• Kimberly Dawn Elgin
• Eric Elick, M.S.
• Brian Eugene Elledge, DO
• Diane M Eller-Boyko, RN,MSW,LCSW

• All providers in Redlands, CA
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.