MEDICARE: DR. ELIZABETH COLEMAN CATES PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	P2741	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	009575	OTHER		VALUE OPTIONS

General Provider Information

NPI Number	:	1679528939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH COLEMAN CATES PH.D.

Provider Business Mailing Address
First Line	:	111 E MAIN ST
Second Line	:	SUITE 202
City	:	JONESBOROUGH
State	:	TN
Zip	:	37659-1317
Country	:	US
Telephone Number	:	423-913-0400
Fax Number	:	423-753-7737

Provider Business Practice Location Address
First Line	:	111 E MAIN ST
Second Line	:	SUITE 202
City	:	JONESBOROUGH
State	:	TN
Zip	:	37659-1317
Country	:	US
Telephone Number	:	423-913-0400
Fax Number	:	423-753-7737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	02/21/2008

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