PHILIP LEE ELLIS PH.D.
NPI 1073549911
Psychologist in Grand Rapids, MI

Active since June 23, 2006PECOS Enrolled
300 68TH ST SE, GRAND RAPIDS, MI 49548(616) 455-5000 Get Directions Write a Review

NPPES record last updated: September 19, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Philip Lee Ellis Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHILIP LEE ELLIS PH.D. (NPI 1073549911) is an individual psychologist in Grand Rapids, Michigan, licensed in Michigan (6301005230) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073549911
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NamePHILIP LEE ELLISCredential: PH.D.
Location Address300 68TH ST SEGrand Rapids, MI 49548-6927
Mailing Address125 S Park St, Ste 325Traverse City, MI 49684-3608 · (231) 715-8466
Sole ProprietorNo
Enumeration DateJune 23, 2006
Last NPPES UpdateSeptember 19, 2017
NPI 1073549911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MI · 6301005230
Definition
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.
300 68TH ST SE, Grand Rapids, MI 49548

Other Identifiers 2

Medicare UPINS07629MI
Medicare PIND16189033MI

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Philip Lee Ellis Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
300 68TH ST SE
GRAND RAPIDS, MI 49548
Social Worker
300 68TH ST SE
GRAND RAPIDS, MI 49548
Behavior Analyst
300 68TH ST SE
GRAND RAPIDS, MI 49548
Social Worker (Clinical)
300 68TH ST SE
GRAND RAPIDS, MI 49548
Social Worker
300 68TH ST SE
GRAND RAPIDS, MI 49548
Psychiatry & Neurology (Psychiatry)
300 68TH ST SE
GRAND RAPIDS, MI 49548
Social Worker (Clinical)
300 68TH ST SE
GRAND RAPIDS, MI 49548
Counselor (Mental Health)
300 68TH ST SE
GRAND RAPIDS, MI 49548

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Philip Ellis's NPI number?

The NPI number for Philip Ellis is 1073549911. It was assigned to this individual provider in the NPPES registry on June 23, 2006.

Where is Philip Ellis located?

Philip Ellis practices at 300 68th St SE, Grand Rapids, MI 49548. The listed phone number is (616) 455-5000.

What is Philip Ellis's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Philip Ellis enrolled in Medicare?

Yes. Philip Ellis is registered in the Medicare PECOS enrollment system.

What insurance does Philip Ellis accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Philip Ellis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Philip Ellis was last updated on September 19, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.