Elaine, Susan

Elaine, Susan is an individual health care provider with primary practice located at Lake Dr. Building 52, Mountain Home TN 37684. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Elaine, Susan can be contacted via phone (423) 439-8000.

Contact Information

Primary practice address
Lake Dr. Building 52 Mountain Home TN 37684
Phone: (423) 439-8000
Fax: (423) 439-2200
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 176 Tennessee

Profile Details

NPI number 1295801512
LBN Legal business name Elaine, Susan
Credentials M.ED., L.M.F.T.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Nov 2nd, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295801512 NPPES
Tennessee Other 176 STATE LICENSE

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