Spectrum Psychological Services
LBN: Carl R. Ellis
Spectrum Psychological Services is an health care organization with primary practice located at 1020 Independence Blvd Suite 204, Virginia Beach VA 23455-5500. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as the primary health care specialty.
Carl R. Ellis can be contacted via phone (757) 640-1882, or through Ellis, Carl Richard via phone (757) 640-1882.
Contact Information
Primary practice address
1020 Independence Blvd Suite 204
Virginia Beach VA 23455-5500
Phone: (757) 640-1882
Fax: (757) 640-0253
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 0810001913 | Virginia |
Profile Details
| NPI number | 1114002581 |
|---|---|
| LBN Legal business name | Carl R. Ellis |
| DBA Doing business as | Spectrum Psychological Services |
| Authorized official | Ellis, Carl Richard ED.D. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 26th, 2006 |
| Last updated | Sep 4th, 2012 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114002581 | NPPES |
| Virginia | Other | 260026000 | OPTIMA HEALTH |
| Virginia | MEDICAID | 007700580 | OPTIMA HEALTH |
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