Jordan Michael Ellis, PHD

Clinical Psychologist · JB Andrews, MD

Individual Active NPI

NPI number 1972167161

Practice location

1060 W Perimeter Rd
JB Andrews, MD 20762-6602
Phone
(240) 857-7186

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NPI record

NPI
1972167161
Entity type
Individual (Type 1)
Enumeration date
April 24, 2019
Last updated
June 16, 2025
Certified
June 16, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Psychologist Primary 103TC0700X 0810007310 VA
Health Psychologist 103TH0004X — —

Mailing address

1100 Wilford Hall Loop
Bldg. 4554, 59 MDW/Gme, Jbsa Lackland
Jbsa Lackland, TX 78236

About Dr. Ellis

Jordan Michael Ellis, PHD is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Psychologist (code 103TC0700X). The practice location is 1060 W Perimeter Rd, JB Andrews, MD 20762-6602. The NPI number 1972167161 was assigned on April 24, 2019 and the record was last updated on June 16, 2025.

Dr. Ellis lists a license in the registry: #0810007310 (VA) for Clinical Psychologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jordan Michael Ellis, PHD?

The NPI number is 1972167161.

What is the phone number of Dr. Ellis?

The phone number listed for the practice location is (240) 857-7186.

Where is Dr. Ellis located?

1060 W Perimeter Rd, JB Andrews, MD 20762-6602.

What is the taxonomy code for Dr. Ellis?

The primary taxonomy code is 103TC0700X – Clinical Psychologist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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