Spectrum Psychological and Neurotherapy PC
NPI 1407221716ActiveOrganization· Psychologist· Virginia Beach, VA
Psychologist in Virginia Beach, Virginia, registered in NPPES in December 2015. The authorized official on file is Carl Richard Ellis, ED.D., Owner/Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1407221716 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 11, 2015 |
| Last updated in NPPES | Aug 15, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
| Psychologist, Clinical Child & Adolescent | 103TC2200X | — | — |
| Social Worker, Clinical | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (VA) |
|---|
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