Grant Martin Ellison, MS LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6361005291 Issued in MI

Practice address

5340 Plymouth Rd Ste 202
Ann Arbor, MI 48105-9341

Phone

(734) 462-3210

NPI assigned

Jun 29, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Victor M. Cruz MD, P.C.

  • Psychiatry Physician
  • Livonia, MI
  • NPI 1023036514
  NPD (past)

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1710360573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 ALAMO CT",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492869709",
            "telephone_number": "989-313-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 PLYMOUTH RD STE 202",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059341",
            "telephone_number": "734-462-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "GRANT",
        "middle_name": "MARTIN",
        "credential": "MS LLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-29",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361005291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley Lynne Ellis, NP
• Keri Taylor Ellis, MA, LPC
• Russell Duane Ellis, COMS, COTA/L
• Sean Brett Ellis, DPT
• Shannon Hope Ellis
• Justin M Ellison, PA-C
• Ryan K Ellison, CRNA
• Jennifer Seidel Ellsworth, RD
• Lindsay Ann Ellsworth, M.D.
• Cassie M Ellul, NP

• Clinical Psychologist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; 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.