| Ellie Mental Health | |
|
14500 Avion Pkwy Ste 315 Chantilly VA 20151-1108 | |
| (703) 260-9978 | |
| (703) 890-2554 |
| Full Name | Ellie Mental Health |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 14500 Avion Pkwy Ste 315, Chantilly, Virginia |
| Authorized Official Name and Position | Stephanie L Afshar (OWNER) |
| Authorized Official Contact | 7038691468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health 14500 Avion Pkwy Ste 315 Chantilly VA 20151-1108 Ph: (703) 260-9978 | Ellie Mental Health 14500 Avion Pkwy Ste 315 Chantilly VA 20151-1108 Ph: (703) 260-9978 |
| NPI Number | 1629787809 |
|---|---|
| Provider Enumeration Date | 11/16/2022 |
| Last Update Date | 09/27/2024 |
| Certification Date | 09/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629787809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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