Carl Richard Ellis in Norfolk - Clinical Child & Adolescent
Carl Richard Ellis - NPI 1821173519
Carl Richard Ellis is a Clinical Child & Adolescent in Norfolk, Virginia. Carl Richard Ellis practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for Carl Richard Ellis is 1821173519. The last update date is 2008-06-12.
Carl Richard Ellis's current location address is 4101 Granby St, Norfolk, Virginia. You can contact this provider via phone number 7576401882 and fax number 7576400253. The mailing address for Carl Richard Ellis is 4101 Granby St, Norfolk, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Carl Richard Ellis |
|---|---|
| Address | 4101 Granby St, Norfolk, Virginia |
| Phone Number | 7576401882 |
| Fax Number | 7576400253 |
| Sole Proprietor | Y |
| Credentials | ED.D. |
NPI Number Detail
| NPI Number | 1821173519 |
|---|---|
| Provider Enumeration Date | 2006-10-25 |
| Last Updated Date | 2008-06-12 |
Provider Mailing Address Detail
| Address | 4101 Granby St |
|---|---|
| City | Norfolk |
| State | Virginia (VA) |
| Post Code | 235041117 |
| Phone Number | 7576401882 |
| Fax Number | 7576400253 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Child & Adolescent |
|---|---|
| Taxonomy | 103Tc2200X |
| Licence No | 810001913 |
|
Definition: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 58231 | VA | ANTHEM BC/BS | |
| 7700580 | VA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Carl Richard Ellis?
The Carl Richard Ellis has been issued the NPI (National Provider Identifier) 1821173519 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Carl Richard Ellis?
The Carl Richard Ellis is physically situated at 4101 Granby St, in the city of Norfolk, state of VA, with the postal code 235041117.
What is the Carl Richard Ellis's specialty and taxonomy code?
The Carl Richard Ellis's specialty is Clinical Child & Adolescent, and the corresponding taxonomy code is 103Tc2200X.
When was the Carl Richard Ellis's 1821173519 issued?
The Carl Richard Ellis's 1821173519 was issued on 2006-10-25.
When was the information regarding Carl Richard Ellis, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Carl Richard Ellis, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2008-06-12.
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