| Ally Mental Health Services, Llc | |
|
7541 Mentor Ave Suites A103 & A104 Mentor OH 44060-5431 | |
| (440) 622-3728 | |
| Not Available |
| Full Name | Ally Mental Health Services, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7541 Mentor Ave, Mentor, Ohio |
| Authorized Official Name and Position | Anna Gray (MEMBER) |
| Authorized Official Contact | 4406223728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ally Mental Health Services, Llc 7541 Mentor Ave Ste A103 Mentor OH 44060-5431 Ph: (440) 457-1112 | Ally Mental Health Services, Llc 7541 Mentor Ave Suites A103 & A104 Mentor OH 44060-5431 Ph: (440) 622-3728 |
| NPI Number | 1619748878 |
|---|---|
| Provider Enumeration Date | 01/15/2024 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Medicare PECOS PAC ID | 1456797372 |
|---|---|
| Medicare Enrollment ID | O20240313002478 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619748878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kimberly A Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760762405 PECOS PAC ID: 0143440479 Enrollment ID: I20141008000829 |
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