NPI Details
DR. Gregory Timothy Ellermann, PHD is a psychologist in Leavenworth, KS. The provider is 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. DR. Gregory Timothy Ellermann, PHD NPI is 1801991195. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
3515 S 4TH ST
PROFESSIONAL ASSOCIATION
LEAVENWORTH, KS
ZIP 66048
Phone: (913) 651-8415
Fax: (913) 772-8580
The enumeration date for this NPI number is 9/13/2006 and was last updated on 10/3/2008.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 103T00000X | Psychologist | | 01582 | MISSOURI | No |
| 2 | 103T00000X | Psychologist | | 860 | KANSAS | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 32816022 | OTHER | KANSAS | KANSAS CITY BCBS |
| 2 | 7030764 | OTHER | | AETNA |
| 3 | 043080 | OTHER | KANSAS | BCBS OF KANSAS |
| 4 | 004517 | OTHER | | BCBS OF KANSAS GROUP |
