Brent Stuart Elliott, CLNICAL PSYCHOLOGIST

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005522 Issued in VA

Practice address

6353 Center Dr
Suite 204
Norfolk, VA 23502-4112

Phone

(757) 461-3313

Fax

(757) 461-8363

NPI assigned

Sep 22, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Norfolk Psychiactric Associates PCGroup PAC ID 7618907551, 13 clinicians

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.

• Norfolk Psychiactric Associates PC

  • Specialist
  • Norfolk, VA
  • NPI 1922198100
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1609325323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6353 CENTER DR",
            "address_2": "SUITE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024112",
            "telephone_number": "757-461-3313",
            "fax_number": "757-461-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6353 CENTER DR",
            "address_2": "SUITE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024112",
            "telephone_number": "757-461-3313",
            "fax_number": "757-461-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "BRENT",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "CLNICAL PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "0810005522",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Elizabeth, LMT
• Kate Elkins
• Kimmy Shin Eller, MS, CCC-SLP
• Lindsey Ellerbe, LCSW
• Alicia Luz Elliott, MD
• Catwana Elliott, LPC
• Cynthia Walker Elliott, NNP
• Leanne Elliott, RN
• Alexander Reed Ellis, M.D., M.SC.
• Belinda Ellis

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.