# DR. GREGORY TIMOTHY ELLERMANN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1801991195
- **Gender:** Man
- **Credential:** PHD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 01582 | MO | — |
| 103T00000X | Psychologist | 860 | KS | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 10/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 004517 | BCBS OF KANSAS GROUP | — |
| 01 | — | 043080 | BCBS OF KANSAS | KS |
| 01 | — | 32816022 | KANSAS CITY BCBS | KS |
| 01 | — | 7030764 | AETNA | — |