Carilyn Claire Ellis, PSYD, MSCP
NPI 1962888388ActiveIndividual· Psychologist· Salem, OR
Psychologist (PSYD, MSCP) in Salem, Oregon, licensed in OR, with an NPI issued in August 2015. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1962888388 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD, MSCP |
| Sole proprietor | Yes |
| NPI issued | Aug 7, 2015 |
| Last updated in NPPES | Mar 5, 2020 |
| Certified by provider | Mar 5, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 2595 | OR |
| Psychologist, Cognitive & Behavioral | 103TB0200X | 2595 | OR |
| Psychologist, Clinical | 103TC0700X | 2595 | OR |
| Psychologist, Health | 103TH0004X | 2595 | OR |
| Psychologist, Group Psychotherapy | 103TP2701X | 2595 | OR |
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 (OR) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Clinical Psychologist |
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