npidexNPI registry + Medicare data

MARY ELLIS, JD,PSYD

Clinical Child & Adolescent Psychologist · VIENNA, VA

Individual Active Opted out of Medicare NPI 1972813467

Taxonomy & licensure

SpecialtyCodePrimaryLicenseState
Clinical Child & Adolescent Psychologist103TC2200X✓0810004323VA

Medicare eligibility

Part B
Yes
DME
Yes
Home health
No
Power mobility
No
Hospice
No

Opted out of Medicare (Clinical Psychologist), effective 2018-04-01 through 2028-04-01.

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.