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

Last updated

Jun 24, 2026By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

• Victor M. Cruz MD, P.C.

  dba Cruz Clinic

  • 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.