CARILYN CLAIRE ELLIS PSYD, MSCP
NPI 1962888388
Psychologist in Salem, OR

Active since August 07, 2015PECOS EnrolledAccepts Medicare Assignment
3857 WOLVERINE ST NE STE 6, SALEM, OR 97305(503) 856-6430(503) 877-1920 Get Directions Write a Review

NPPES record last updated: March 5, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 5, 2020, Aug 14, 2019, Feb 18, 2016 (3 updates tracked since 2016).

About Carilyn Claire Ellis Psyd, Mscp NPPES

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

CARILYN CLAIRE ELLIS PSYD, MSCP (NPI 1962888388) is an individual psychologist in Salem, Oregon, licensed in Oregon (2595) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1962888388
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameCARILYN CLAIRE ELLISCredential: PSYD, MSCP
Location Address3857 WOLVERINE ST NE STE 6Salem, OR 97305-4274
Mailing Address920 Sw Range DriveWaldport, OR 97394-3035 · (541) 563-3197 · Fax (541) 563-6027
Fax(503) 877-1920
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateAugust 7, 2015
Last NPPES UpdateMarch 5, 20203 updates tracked since enumeration
NPPES CertifiedMarch 5, 2020
NPI 1962888388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in OR · 2595
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.
Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X · License 2595 (OR)
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 2595 (OR)
Also ListedPsychologist · HealthTaxonomy 103TH0004X · License 2595 (OR)
Also ListedPsychologist · Group PsychotherapyTaxonomy 103TP2701X · License 2595 (OR)
3857 WOLVERINE ST NE STE 6, Salem, OR 97305

Other Identifiers 1

OtherR185419OR · Medicare

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 and accepts Medicare assignment

Carilyn Claire Ellis Psyd, Mscp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931401684
PECOS Enrollment IDI20160112001822
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

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

Community/Behavioral Health
3857 WOLVERINE ST NE STE 6
SALEM, OR 97305

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 Carilyn Ellis's NPI number?

The NPI number for Carilyn Ellis is 1962888388. It was assigned to this individual provider in the NPPES registry on August 7, 2015.

Where is Carilyn Ellis located?

Carilyn Ellis practices at 3857 Wolverine St NE Ste 6, Salem, OR 97305. The listed phone number is (503) 856-6430.

What is Carilyn Ellis's specialty?

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

Is Carilyn Ellis enrolled in Medicare?

Yes. Carilyn Ellis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Carilyn Ellis accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Carilyn 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 Carilyn Ellis was last updated on March 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.