DR. STEPHEN SEALS ELLIOTT (NPI# 1417009937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417009937 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN SEALS ELLIOTT |
| Credential | PHD |
| Practice Address |
3205 Randall Pkwy Ste 105 Wilmington NC 28403-2565 |
| Mailing Address |
Po Box 538622 Atlanta GA 30353-8622 |
| Practice Telephone | 9107429243 |
| Practice Fax Number | 8887461787 |
| Mailing Telephone | 9107429243 |
| Mailing Fax Number | 8887461787 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2019-01-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
1010 | NC | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
1010 | NC | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 283 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | RR MEDICARE | P01126726 | 01 |
| NC | 6000042 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346674983 | Stephen Trader Elliott Jr. | Registered Nurse | Kamc, Ngh, Mc 1, Building 12, Apt. 8, Er Mail Cose 6338, Jeddah, MAKKAH 21423 | 2013-08-31 |
| 1437160256 | Stephen P Elliott | Family Medicine | 11979 Fishers Crossing Dr, Fishers, IN 46038-2778 | 2006-08-10 |
| 1669471611 | Stephen Mark Elliott | Social Worker | 320 Central Park W, Suite 1 E, New York, NY 10025-7659 | 2005-07-20 |
| 1528678455 | Stephen Elliott | Adult Companion | 1500 E Tropicana Ave, Las Vegas, NV 89119-6514 | 2020-08-05 |
| 1215590054 | Stephen Michael Elliott | Student in an Organized Health Care Education/Training Program | 1000 Montauk Hwy, West Islip, NY 11795-4927 | 2019-04-17 |
| 1619215787 | Stephen Charles Elliott | General Practice | 1006 Depot Hill Rd, Broomfield, CO 80020-6721 | 2013-01-24 |
| 1952500183 | Stephen C Elliott | Psychiatry & Neurology | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2007-07-17 |
| 1023127644 | Stephen J Elliott | Pediatrics | 15031 Rinaldi St, Mission Hills, CA 91345 | 2006-08-29 |
| 1710971478 | Stephen C Elliott | Pediatrics | 1212 Pleasant St, Suite 300, Des Moines, IA 50309-1453 | 2005-09-08 |
| Street Address |
3205 RANDALL PKWY STE 105 |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-2565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912992777 | Robert J. Anderson | Psychologist | 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 | 2005-09-16 |
| 1295372324 | Jason Darden | Nurse Practitioner | 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 | 2019-12-09 |
| 1730742552 | Debrah Teachey Marshburn | Social Worker | 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 | 2019-04-17 |
| 1700372620 | Meredith Morrow Hartsell | Nurse Practitioner | 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 | 2018-07-03 |
| 1619474202 | Wesley Kirby Smith | Psychologist | 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 | 2018-04-10 |
| 1205331691 | Laurie Legrand | Social Worker | 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 | 2018-03-27 |
| 1326541574 | Carol Elizabeth Cameron-matthews | Nurse Practitioner | 3205 Randall Pkwy Ste 105, Wilmington, NC 28403 | 2018-03-14 |
| 1093238768 | Erica Rochelle Alford | Social Worker | 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 | 2017-07-24 |
| 1386166684 | Rebecca Ashley Kalinoski | Nurse Practitioner | 3205 Randall Pkwy Ste 105, Wilmington, NC 28403 | 2017-07-10 |
| 1639601594 | Mimi Elizabeth Crawley | Social Worker | 3205 Randall Pkwy Ste 105, Wilmington, NC 28403-2565 | 2017-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
| 1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
| 1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
| 1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
| 1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
| 1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
| Find all providers in zip 28403 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193114 | Inroad Behavioral and Social Health | Psychologist | 3304 Old Capitol Trl Ste 201, Wilmington, DE 19808-6210 | 2020-04-24 |
| 1609496124 | Doko Medical Inc. | Psychologist | 3422 Old Capitol Trail, # 626, Wilmington, DE 19808 | 2020-04-24 |
| 1407487226 | James Francis Skane Jr. | Psychologist | 123 S 29th St, Wilmington, NC 28403-1223 | 2020-01-30 |
| 1346733631 | Renee Davis | Psychologist | 920 Morningdale Dr, Wilmington, DE 19810-1458 | 2018-06-11 |
| 1982103206 | Elizabeth De La Pena | Psychologist | 1333 Island Ave, Wilmington, CA 90744-2501 | 2018-02-02 |
| 1841728532 | Rogelio Mercado | Psychologist | 1801 Rockland Rd Ste 201, Wilmington, DE 19803-3648 | 2017-05-25 |
| 1497289375 | Aitza Galarza-hernandez | Psychologist | 7517 Quail Woods Rd, Wilmington, NC 28411-7273 | 2017-04-17 |
| 1407206816 | Leeann Trudel | Psychologist | 114 Rockland Cir, Wilmington, DE 19803-4542 | 2016-06-16 |
| 1972964427 | Ostin M Warren | Psychologist | 3411 N Rockfield Dr, Wilmington, DE 19810-3237 | 2016-03-11 |
| 1164882353 | Erika Blinn Geisler | Psychologist | 330 Military Cutoff Rd, Suite A-4, Wilmington, NC 28405-8356 | 2016-03-01 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28403 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.