Provider Demographics
NPI:1679528939
Name:CATES, ELIZABETH COLEMAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:COLEMAN
Last Name:CATES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-1317
Mailing Address - Country:US
Mailing Address - Phone:423-913-0400
Mailing Address - Fax:423-753-7737
Practice Address - Street 1:111 E MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-1317
Practice Address - Country:US
Practice Address - Phone:423-913-0400
Practice Address - Fax:423-753-7737
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2741103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
009575OtherVALUE OPTIONS
TN3680021Medicare PIN