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

Stacy Ellenberg, PHD

Individual provider Clinical Psychologist · NPI 1285372870

Stacy Ellenberg, PHD is a Clinical Psychologist in Ithaca, New York. Qualified in 2021, 5 years ago. Practices with Suny Health Science Center at Syracuse, a 210-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2022
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

6 Yardley Grn
Ithaca, NY 14850-1259
Phone: (508) 245-2276
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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 112047-01 (NY)

Record details

NPI number1285372870
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedMay 24, 2022
Last updated in NPPESMay 24, 2022
Certification dateMay 24, 2022
Mailing address6 Yardley Grn, Ithaca, NY 14850-1259

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Suny Health Science Center At Syracuse — 210 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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