Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. LAURA ALISON ELLICK, PH.D.
Active Sole ProprietorDR. LAURA ALISON ELLICK, PH.D. is a Clinical Psychologist healthcare provider located in KINGS PARK, New York. NPI 1407875172 is currently active in the NPPES registry. Verify at CMS.
Clinical Psychologist · KINGS PARK, NY
Registration Details
- NPI Number
- 1407875172
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 19, 2006 (20.101645165951 yrs)
- Last Updated
- Aug 17, 2007
- Licenses
-
014960 (NY)014960 (NY)014960 (NY)014960 (NY)014960 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12 RENWICK AVESUITE 103KINGS PARK, NY, 117543709Browse NY providers · Browse ZIP 11754
- Phone
- 5166356186
- Primary Specialty
-
Clinical Psychologist
103TC0700X
- Additional Specialty
- Cognitive & Behavioral Psychologist
- Additional Specialty
- Exercise & Sports Psychologist
- Additional Specialty
- Geriatric Psychologist
- Additional Specialty
- Child, Clinical Psychologist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.