DR. GLENN THOMAS ELLIS (NPI# 1184712820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184712820 |
| Entity Type | Individual |
| Full Name | DR. GLENN THOMAS ELLIS |
| Credential | PHD |
| Practice Address |
815 2nd Ave No Columbus MS 39701 |
| Mailing Address |
815 2nd Ave North Columbus MS 39701 |
| Practice Telephone | 6623277388 |
| Practice Fax Number | 6623291177 |
| Mailing Telephone | 6623277388 |
| Mailing Fax Number | 6623291177 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 105 | MS | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00115223 | 05 |
| Street Address |
815 2ND AVE NO |
| City | COLUMBUS |
| State | MS |
| Zip Code | 39701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386734283 | Francis Jewell Baird Jr. | Counselor | 815 2nd Ave No, Columbus, MS 39701 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902370828 | Southern Hospitality Transportation | Non-emergency Medical Transport (VAN) | 702 #1 Hwy 45 North, Columbus, MS 39701 | 2019-01-14 |
| 1457844466 | Red 2 Black Consulting, LLC | Nurse Practitioner | 68 Brickerton St, Columbus, MS 39701 | 2018-06-13 |
| 1194134478 | John Wesley Conn | Counselor | 1001 Maint St, Columbus, MS 39701 | 2014-08-12 |
| 1902109903 | Jeffrey Wayne Carter | Contractor | 1809 7th Avenue North, Columbus, MS 39701 | 2010-12-13 |
| 1215193933 | The Clinic At Elm Lake, P.a. | Legal Medicine | 3700 N Frontage Rd, Columbus, MS 39701 | 2008-08-01 |
| 1134322886 | Johanna R Price | Speech-Language Pathologist | 1100 College Street Muw 1340, Columbus, MS 39701 | 2007-06-08 |
| 1396952057 | Roland Franklin Colom | Dentist | 907 Military Rd, Columbus, MS 39701 | 2007-05-16 |
| 1821142902 | Bob W Meek | Counselor | 200 6th St North, Suite 401, Columbus, MS 39701 | 2007-01-23 |
| 1447324173 | Tolley Valerie | Durable Medical Equipment & Medical Supplies | 818 2nd Ave North, Columbus, MS 39701 | 2006-11-17 |
| 1548347081 | Kimberly Mullin | Counselor | 700 10th Ave South, Columbus, MS 39701 | 2006-11-01 |
| Find all providers in zip 39701 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184244 | Works of Faith Wellness and Consultation, LLC | Psychologist | 867 Mosaic Ct, Columbus, OH 43230-3835 | 2020-11-02 |
| 1013525120 | Renato Popovic | Psychologist | 2601 Cross Country Dr, Columbus, GA 31906-1801 | 2020-07-15 |
| 1518510155 | Michael Vilensky | Psychologist | 1441 Phale D Hale Drive, Columbus, OH 43203 | 2019-07-23 |
| 1740766559 | Smarter Therapy, LLC | Psychologist | 371 Forest St, Columbus, OH 43206-2221 | 2018-07-15 |
| 1568971570 | Dru Garcia | Psychologist | 999 Polaris Pkwy Ste 102, Columbus, OH 43240-2051 | 2017-09-21 |
| 1356712970 | Brett Allen Coney | Psychologist | 10047 Big Hand Rd, Columbus, MI 48063-2801 | 2015-10-08 |
| 1326446352 | Leila Phelps-ba | Psychologist | 6677 Kennerdown St, Columbus, OH 43229-1517 | 2014-12-08 |
| 1013257161 | Wesley Howard Sylvia | Psychologist | 1800 Harmon Ave, Columbus, OH 43223-3827 | 2013-02-27 |
| 1437465317 | Shonali C Raney | Psychologist | 4041 N High St Ste 300g, Columbus, OH 43214-3200 | 2010-08-30 |
| 1124331699 | Teresa Anne Young | Psychologist | 1520 Old Henderson Rd Ste E, Columbus, OH 43220 | 2010-07-26 |
| Find all providers in COLUMBUS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.