Mary Elizabeth Statum, LPC-MHSP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC0000002198 Issued in TN

Practice address

6630 Summer Knoll Cir
Suite 101
Bartlett, TN 38134-2875

Phone

(901) 550-7867

NPI assigned

Apr 24, 2014

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

Other names 1

• Mary Harris Statum Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1841610102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 SUMMER KNOLL CIR",
            "address_2": "SUITE 101",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342875",
            "telephone_number": "901-550-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 SUMMER KNOLL CIR",
            "address_2": "SUITE 101",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342875",
            "telephone_number": "901-550-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATUM",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "LPC0000002198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "STATUM",
            "middle_name": "HARRIS",
            "credential": "LPC-MHSP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.