Brent Michael Ellens in Grand Rapids - Clinical
Brent Michael Ellens - NPI 1932145729
Brent Michael Ellens is a Clinical in Grand Rapids, Michigan. Brent Michael Ellens practices all healthcare services and medical treatments related to Clinical. The NPI Number for Brent Michael Ellens is 1932145729. The last update date is 2022-01-07.
Brent Michael Ellens's current location address is 300 68th St Se, Grand Rapids, Michigan. You can contact this provider via phone number 6164555000. The mailing address for Brent Michael Ellens is 300 68th St Se, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brent Michael Ellens |
|---|---|
| Address | 300 68th St Se, Grand Rapids, Michigan |
| Phone Number | 6164555000 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1932145729 |
|---|---|
| Provider Enumeration Date | 2006-06-21 |
| Last Updated Date | 2022-01-07 |
Provider Mailing Address Detail
| Address | 300 68th St Se |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495486927 |
| Phone Number | 6164555000 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 6301011810 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P101976540 | MI | BC/BS |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Brent Michael Ellens by the Centers for Medicare & Medicaid Services?
The Brent Michael Ellens has been assigned the NPI (National Provider Identifier) 1932145729 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical location address where Brent Michael Ellens's facilities are situated?
The facilities of Brent Michael Ellens are physically located at the following address: 300 68Th St Se, Grand Rapids, MI, 495486927.
What is Brent Michael Ellens's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Brent Michael Ellens is Clinical, and the taxonomy code that classifies this field of practice is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1932145729 to Brent Michael Ellens?
The Centers for Medicare & Medicaid Services assigned the 1932145729 to Brent Michael Ellens on 2006-06-21.
When was the information related to Brent Michael Ellens most recently updated or refreshed?
The details pertaining to the Brent Michael Ellens, including its address, specialty, and other relevant information, were last updated or refreshed on 2022-01-07.