Lisa B Ellis, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS016670 Issued in PA

Practice address

1251 S Cedar Crest Blvd
Suite 303D
Allentown, PA 18103-6382

Phone

(484) 838-5855

Fax

(610) 433-5751

NPI assigned

Jul 21, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

George Washington University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Center for Integrative Psychotherapy PC

  • Clinical Psychologist
  • Allentown, PA
  • NPI 1962461236
  Medicare reassignment NPD
• Lisa Ellis Psy.D

  • Clinical Psychologist
  • Allentown, PA
  • NPI 1861938730
  NPD (past) Authorized official

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1134432081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 S CEDAR CREST BLVD",
            "address_2": "SUITE 303D",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036382",
            "telephone_number": "484-838-5855",
            "fax_number": "610-433-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 S CEDAR CREST BLVD",
            "address_2": "SUITE 303D",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036382",
            "telephone_number": "484-838-5855",
            "fax_number": "610-433-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LISA",
        "middle_name": "B",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Luzzetti Elizalde
• Averi Ann Ellis, MS,CCC-SLP
• Colin Ellis, PT, DPT
• Jeremy Michael Ellis, M.D.
• Jessica Ellis
• Khadija Elmagarmid, MD
• Sarah Elrod, DO
• Elwyn
• Elwyn
• Elwyn

• Psychologist in Allentown, PA
• Providers in Allentown, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.