Mesha Lygia Ellis, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003274 Issued in GA

Practice address

2255 Cumberland Parkway 500-140
Atlanta, GA 30339-4524

Phone

(678) 538-6450

Fax

(404) 478-8413

NPI assigned

May 31, 2006

Last updated

Apr 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ellis Evaluation Services, LLC

  dba Ellis Evaluation & Consulting Services

  • Clinical Psychologist
  • Atlanta, GA
  • NPI 1730528464
  Authorized official Same address or phone
• The Institute for Relationship Wellness & Sexual Health PC

  • Clinical Psychologist
  • Atlanta, GA
  • NPI 1922566553
  NPD (past) Authorized official
• Branko Radisavljevic M.D. Inc.

  • Psychiatry Physician
  • Long Beach, CA
  • NPI 1982941902
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587859200000",
    "number": "1255378386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 CUMBERLAND PARKWAY 500-140",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394524",
            "telephone_number": "678-538-6450",
            "fax_number": "404-478-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CUMBERLAND PARKWAY 500-140",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394524",
            "telephone_number": "678-538-6450",
            "fax_number": "404-478-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MESHA",
        "middle_name": "LYGIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-04-26",
        "certification_date": "2020-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20263",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "PSY003274",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenna Healy Ellis, MD
• Kimberly Lynn Ellis, CPNP-AC
• Latrese Ann Ellis, NP
• Linda Ellis
• Lucia Ellis, LCSW
• Porshay Ellis
• Robin Marissa Liever Ellis, PT, DPT
• Shakesta Ellis, LPC
• Shayla Ellis, M.ED., BCBA, LBA
• Stephanie Nicole Hart Ellis, NP-C

• Clinical Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2020; 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.