Organization
CARL R. ELLIS
Active
Other names
Spectrum Psychological Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL RICHARD ELLIS ED.D. (OWNER)
(757) 640-1882
Entity
Organization
Contact information
Practice address
1020 INDEPENDENCE BLVD, SUITE 204, VIRGINIA BEACH, VA 23455-5500
(757) 640-1882
(757) 640-0253
Mailing address
1020 INDEPENDENCE BLVD, SUITE 204, VIRGINIA BEACH, VA 23455-5500
(757) 640-1882
(757) 640-0253
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0810001913
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007700580
—
VA
01
—
260026000
OPTIMA HEALTH
VA
Enumeration date
10/26/2006
Last updated
09/04/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us