Janice Ann Ellery, PSYD
Individual provider Active NPI Clinical Psychologist · Dania, FL
NPI 1477517795 · NPPES record last updated Jan 23, 2012
Key facts
- NPI
- 1477517795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY0005208 (FL)
- Practice address
- 214 SW 2ND PL
Dania, FL 33004-3957 - Phone
- (954) 683-8972
- Fax
- (954) 923-4521
- NPI assigned
- Apr 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY0005208 | FL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ann Monis, P.a. | Clinical | Past | Accepting new patients |
| Cotler Healthcare & Development Inc. | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY0005208 | FL | Yes |
Addresses
Primary practice location
214 SW 2ND PL
Dania, FL 33004-3957
Mailing address
214 SW 2ND PL
Dania, FL 33004-3957
Phone (954) 683-8972
Other providers in Dania, FL
- Dr Robert Jacobs PA
- Lauren Dressel
- Elie Dumeny Jr.
- Essien Ebongo
- Edward C Miller OD PA
- Melissa Enriquez Fabregas
- Ev Med Supply LLC
- Howard Finnk
- Chena L Frazier Henry
- Lyubov Gargun
All providers in Dania, FL · Clinical Psychologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.