Provider Demographics
NPI:1023152964
Name:SUMMERS, ELAINE MARIE (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:MARIE
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MS
Other - First Name:ELAINE
Other - Middle Name:MARIE
Other - Last Name:RIGBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:7011 ARCADIAN CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-9121
Mailing Address - Country:US
Mailing Address - Phone:941-916-8816
Mailing Address - Fax:
Practice Address - Street 1:730 COURTLAND ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1316
Practice Address - Country:US
Practice Address - Phone:407-975-3800
Practice Address - Fax:407-975-3900
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 2249106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7684193 00OtherMEDICAID