Ellermann, Gregory Timothy

Ellermann, Gregory Timothy is an individual health care provider with primary practice located at 3515 S 4Th St Professional Association, Leavenworth KS 66048. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Ellermann, Gregory Timothy can be contacted via phone (913) 651-8415.

Contact Information

Primary practice address
3515 S 4Th St Professional Association Leavenworth KS 66048
Phone: (913) 651-8415
Fax: (913) 772-8580
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 860 Kansas
Behavioral Health & Social Service Providers / Psychologist 103T00000X 01582 Missouri

Profile Details

NPI number 1801991195
LBN Legal business name Ellermann, Gregory Timothy
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Oct 3rd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801991195 NPPES
Kansas Other 043080 BCBS OF KANSAS
Kansas Other 7030764 BCBS OF KANSAS
Kansas Other 004517 BCBS OF KANSAS
Kansas Other 32816022 BCBS OF KANSAS

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