Active NPI
Laura Ellis, PH.D.
- Psychologist
- Bellingham, WA
National Provider Identifier
1407962756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY00002510
- Practice address
- 1118 Finnegan Way # 104
Bellingham, WA 98225-6622 - Phone
- (360) 319-3022
- Fax
- (360) 734-5471
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY00002510 | WA | Primary |
Addresses
Primary practice location
1118 Finnegan Way # 104
Bellingham, WA 98225-6622
Mailing address
1118 Finnegan Way # 104
Bellingham, WA 98225-6622
Phone (360) 319-3022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00002510 | WA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associates in Mental Health | Psychologist | 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": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407962756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1118 FINNEGAN WAY # 104",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982256622",
"telephone_number": "360-319-3022",
"fax_number": "360-734-5471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1118 FINNEGAN WAY # 104",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982256622",
"telephone_number": "360-319-3022",
"fax_number": "360-734-5471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "LAURA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY00002510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.