Center for Excellence

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

0810001913 Issued in VA

Legal business name

CENTER FOR EXCELLENCE

Doing business as

C. Rick Ellis, Ed.D.

Practice address

4101 Granby St
Suite 301
Norfolk, VA 23504-1117

Phone

(757) 640-1882

Fax

(757) 640-0253

NPI assigned

Dec 18, 2007

Last updated

Dec 18, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Carl Richard Ellis, ED.D.NPI 1821173519

Title

Sole Proprietor

Phone

(757) 640-1882

Specialties & licenses 1

Addresses

Other names 1

• C. Rick Ellis, Ed.D. Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carl Richard Ellis, ED.D.

  • Clinical Child & Adolescent Psychologist
  • Norfolk, VA
  • NPI 1821173519
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1033393798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 GRANBY ST",
            "address_2": "SUITE 301",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235041117",
            "telephone_number": "757-640-1882",
            "fax_number": "757-640-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 GRANBY ST",
            "address_2": "SUITE 301",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235041117",
            "telephone_number": "757-640-1882",
            "fax_number": "757-640-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR EXCELLENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "757-640-1882",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810001913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C. Rick Ellis, Ed.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Child & Adolescent Psychologist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Clinical Child & Adolescent Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.