SUZANNE ELLIS MIKKELSON M.A.
NPI 1578740924
Marriage & Family Therapist in Fayetteville, NC

Q: What is Suzanne Mikkelson's NPI number?

The NPI number for Suzanne Mikkelson is 1578740924. It was assigned to this individual provider in the NPPES registry on January 29, 2008.

Q: What is Suzanne Mikkelson's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Suzanne Mikkelson was last updated on January 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 29, 2008PECOS Enrolled

114 HIGHLAND AVE, FAYETTEVILLE, NC 28305(910) 484-0176(910) 484-5781 Get Directions Write a Review

NPPES record last updated: January 29, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Suzanne Ellis Mikkelson M.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUZANNE ELLIS MIKKELSON M.A. (NPI 1578740924) is an individual marriage & family therapist in Fayetteville, North Carolina, licensed in North Carolina (904) and active in the NPI registry since January 2008. She is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1578740924

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameSUZANNE ELLIS MIKKELSONCredential: M.A.

Location Address114 HIGHLAND AVEFayetteville, NC 28305-5306

Mailing Address114 Highland AveFayetteville, NC 28305-5306 · (910) 484-0176 · Fax (910) 484-5781

Phone(910) 484-0176

Fax(910) 484-5781

Sole ProprietorNo

Medical School CMSOtherGraduated 1995

Enumeration DateJanuary 29, 2008

✔ NPI 1578740924 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in NC · 904

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

114 HIGHLAND AVE, Fayetteville, NC 28305

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Suzanne Ellis Mikkelson M.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8224542030

PECOS Enrollment IDI20250703003138

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELISSA MARTHA REED CMHC

Counselor (Professional)