Lawrence Christian Elledge, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

T-LP1978 Issued in KS

Practice address

University of Tennessee
1404 Circle Drive, Austin Peay, 301F
Knoxville, TN 37996-4503

Phone

(865) 974-1958

NPI assigned

Apr 25, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1992063184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF TENNESSEE",
            "address_2": "1404 CIRCLE DRIVE, AUSTIN PEAY, 301F",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379964503",
            "telephone_number": "865-974-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF TENNESSEE",
            "address_2": "1404 CIRCLE DRIVE, AUSTIN PEAY, 301F",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379964503",
            "telephone_number": "865-974-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEDGE",
        "first_name": "LAWRENCE",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "T-LP1978",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "KS",
            "license": "T-LP1978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra K Elkins, MD
• Tony Allen Elkins, APRN, BC
• April Ella
• Allison Renee Elledge, PHD
• Jordan Elledge, PT, DPT
• Donald T. Ellenburg, M.D.
• Joseph Trent Ellenburg, D.O.
• Nathaniel Robert Ellens, MD
• Christopher R Ellington, MD
• Elizabeth Ellington, FNP

• Clinical Child & Adolescent Psychologist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinical Child & Adolescent Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.