Active NPI
Elaine Lenore Ensign, PHD
- Clinical Psychologist
- Kingston, TN
National Provider Identifier
1104896885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P1360
- Practice address
- 1002 Bradford Way
Kingston, TN 37763 - Phone
- (865) 376-1585
- Fax
- (865) 376-1587
- NPI assigned
- Jan 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P1360 | TN | Primary |
Addresses
Primary practice location
1002 Bradford Way
Kingston, TN 37763
Mailing address
1002 Bradford Way
Kingston, TN 37763
Phone (865) 376-1585
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0113007 | Other | TN | BLUE CROSS BLUE SHIELD |
| 3682131 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2022 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1360 | TN | MD | Clinical Psychologist |
| 1366 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert Keith Albiston | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104896885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1002 BRADFORD WAY",
"city": "KINGSTON",
"state": "TN",
"postal_code": "37763",
"telephone_number": "865-376-1585",
"fax_number": "865-376-1587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 BRADFORD WAY",
"city": "KINGSTON",
"state": "TN",
"postal_code": "37763",
"telephone_number": "865-376-1585",
"fax_number": "865-376-1587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENSIGN",
"first_name": "ELAINE",
"middle_name": "LENORE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-25",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P1360",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0113007",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3682131",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingston, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.