Healthcare Provider Details

I. General information

NPI: 1376335679
Provider Name (Legal Business Name): ELIZABETH SARAH GELLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HILLSBORO PIKE APT 135
NASHVILLE TN
37215-1334
US

IV. Provider business mailing address

3000 HILLSBORO PIKE APT 135
NASHVILLE TN
37215-1334
US

V. Phone/Fax

Practice location:
  • Phone: 781-801-2346
  • Fax:
Mailing address:
  • Phone: 781-801-2346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4970
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8237
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5440
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: