Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Donovan Ellis, PHD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1124794243

Dr. Donovan Ellis, PHD is a Clinical Psychologist in Atlanta, Georgia. Qualified in 2022, 4 years ago. Practices with The Emory Clinic Inc, a 3,500-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
4
Licensed in
GA
In the registry since
2021
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

12 Executive Park Dr NE
Atlanta, GA 30329-2206
Phone: (404) 941-5381
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY004807 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1124794243
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedAugust 18, 2021
Last updated in NPPESAugust 26, 2024
Certification dateAugust 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice The Emory Clinic Inc — 3500 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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