| Ellie Mental Health | |
|
1350 Campus Pkwy Ste 101 Wall Township NJ 07753-6821 | |
| (732) 924-5589 | |
| Not Available |
| Full Name | Ellie Mental Health |
|---|---|
| Speciality | Counselor |
| Location | 1350 Campus Pkwy Ste 101, Wall Township, New Jersey |
| Authorized Official Name and Position | Ellen Sweeney (CLINIC DIRECTOR) |
| Authorized Official Contact | 7328149401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health 1350 Campus Pkwy Ste 101 Wall Township NJ 07753-6821 Ph: (732) 924-5589 | Ellie Mental Health 1350 Campus Pkwy Ste 101 Wall Township NJ 07753-6821 Ph: (732) 924-5589 |
| NPI Number | 1033997192 |
|---|---|
| Provider Enumeration Date | 09/20/2023 |
| Last Update Date | 12/28/2023 |
| Certification Date | 10/24/2023 |
| Medicare PECOS PAC ID | 2961847066 |
|---|---|
| Medicare Enrollment ID | O20240228003605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033997192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Ellen Sweeney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114398120 PECOS PAC ID: 3678918786 Enrollment ID: I20240228004234 |
| Provider Name | Tara Virginia Clifford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841839412 PECOS PAC ID: 3779928817 Enrollment ID: I20240228004812 |
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