Holly Ellis

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004210 Issued in VA

Practice address

107 Carpenter Dr Ste 210
Sterling, VA 20164-4468

Phone

(703) 297-4368

NPI assigned

Aug 31, 2019

Last updated

Aug 31, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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.

• Loudoun Psychological Services, LLC

  dba Loudoun Psychological Services

  • Psychologist
  • Leesburg, VA
  • NPI 1427422385
  NPD (past)

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

{
    "created_epoch": "1567209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567209600000",
    "number": "1912555095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 BERRY ST",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220422401",
            "telephone_number": "571-730-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CARPENTER DR STE 210",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201644468",
            "telephone_number": "703-297-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-31",
        "last_updated": "2019-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kehinde Hassanat Elisha, DNP, PMHNP-BC, APRN
• Karim Elkenawy, DDS
• Maadhava Ellaurie, MD
• Ellie Hsieh, LMFT, LLC
• Franklin William Ellis, LCSW-C
• Roshanak Emam, PHARM D
• Sheryl Embling
• Emeritus Corporation (Brookdale Sterling)
• Emka Acupuncture (Emily Hatt, LAc)
• Empowered Minds ABA, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2019; 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.