Paul Russell Ellison, PSYD, LP
NPI 1326374117ActiveIndividual· Psychologist, Clinical· St Louis Park, MN
Psychologist, Clinical (PSYD, LP) with Associated Clinic of Psychology Inc, practicing in St Louis Park, Minnesota. Medicare paid $4,091 for services to 17 patients in 2024.
Overview
| NPI | 1326374117 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD, LP |
| Sole proprietor | No |
| NPI issued | Oct 28, 2009 |
| Last updated in NPPES | Mar 18, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | LP6366 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 17 |
|---|---|
| Services billed | 64 across 6 procedure codes |
| Paid by Medicare | $4,091 |
Education and affiliations
| Graduation year | 2009 |
|---|---|
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
Medical group
- Associated Clinic of Psychology IncWest St Paul, MN · 137 clinicians
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All 69 clinical psychologists in St Louis Park · All clinical psychologists in Minnesota