Oren Michael Ellis, LPE

Individual provider Active NPI Clinical Psychologist · Talbott, TN

NPI 1114919636 · NPPES record last updated Jul 6, 2012

Key facts

NPI
1114919636
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PE1721 (TN)
Practice address
6350 W Andrew Johnson Hwy
Talbott, TN 37877-8605
Phone
(423) 587-7337
Fax
(423) 586-0614
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PE1721TNMDClinical Psychologist

Interoperability endpoints

  • Direct secure messaging: oren.ellis.p1@direct.cherokeehealth.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PE1721 TN Yes

Addresses

Primary practice location

6350 W Andrew Johnson Hwy
Talbott, TN 37877-8605

Mailing address

6350 W a J Hwy
Department 100
Talbott, TN 37877-8605
Phone (800) 355-3565

Other providers in Talbott, TN

All providers in Talbott, TN · Clinical Psychologist in Tennessee

Sources for this page

Verify at the official NPI Registry.