Individual provider Active NPI

Ellen L Lessans, PSY.D.

  • Psychologist
  • Rockville, MD
National Provider Identifier
1932115797
Registry record updated Apr 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3066 Issued in MD
Practice address
6112 Rosemont Cir
Rockville, MD 20852-3554
Phone
(301) 570-3310
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3066 MD Primary

Addresses

Primary practice location

6112 Rosemont Cir
Rockville, MD 20852-3554

Mailing address

6112 Rosemont Cir
Rockville, MD 20852-3554
Phone (301) 570-3310

Other names 1

  • Dr. Ellen Lee Rosenberg-Blommestyn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20101123000223 DC Practitioner - Clinical Psychologist 0648464503 Practice locations: Rockville, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6112 Rosemont Cir
Rockville, MD 20852-3554
Phone (301) 570-3310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712966400000",
    "number": "1932115797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6112 ROSEMONT CIR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523554",
            "telephone_number": "301-570-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 ROSEMONT CIR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523554",
            "telephone_number": "301-570-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSANS",
        "first_name": "ELLEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-04-13",
        "certification_date": "2024-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "3066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "ROSENBERG-BLOMMESTYN",
            "middle_name": "LEE",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.