Timothy Andrew Ellsworth, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY1000280 Issued in DC

Practice address

3801 Fairfax Dr 61
Arlington, VA 22203-1762

Phone

(571) 317-1003

Fax

(888) 220-4899

NPI assigned

Jan 8, 2007

Last updated

Jun 1, 2021By the provider in NPPES

Sex

Male

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 DC, VA2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psychotherapy Associates of the DMV

  • Clinical Psychologist
  • Washington, DC
  • NPI 1528675212

  VA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1568510212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 FAIRFAX DR STE 61",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031762",
            "telephone_number": "571-317-1003",
            "fax_number": "888-220-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 FAIRFAX DR 61",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031762",
            "telephone_number": "571-317-1003",
            "fax_number": "888-220-4899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Connecticut Ave NW Ste 401",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200091169",
            "country_code": "US",
            "telephone_number": "571-317-1003",
            "fax_number": "888-220-4899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "TIMOTHY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1000280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Elliott
• John Jeffrey Elliott, MD
• Timothy Elliott, LCSW
• Andy D Ellis, HS2
• Marianne Greely Ellis, PHD
• Sherif Elmahdy, M.D.
• Ahmad Elmohtaseb, DDS
• Natalie Elwell
• Elysian Psychological Services, PLLC
• Emerald Leaf Counseling LLC

• Clinical Psychologist in Arlington, VA
• Providers in Arlington, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.