| Ellie Mental Health - Lake Worth Florida | |
|
2290 10th Ave N Ste 601 Lake Worth FL 33461-6618 | |
| (917) 855-2799 | |
| Not Available |
| Full Name | Ellie Mental Health - Lake Worth Florida |
|---|---|
| Speciality | Counselor |
| Location | 2290 10th Ave N Ste 601, Lake Worth, Florida |
| Authorized Official Name and Position | Gregg Melnick (OWNER) |
| Authorized Official Contact | 9178552799 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health - Lake Worth Florida 111 Se 1st Ave Apt 405 Delray Beach FL 33444-3796 Ph: (917) 855-2799 | Ellie Mental Health - Lake Worth Florida 2290 10th Ave N Ste 601 Lake Worth FL 33461-6618 Ph: (917) 855-2799 |
| NPI Number | 1942081872 |
|---|---|
| Provider Enumeration Date | 10/06/2023 |
| Last Update Date | 10/14/2023 |
| Certification Date | 10/14/2023 |
| Medicare PECOS PAC ID | 9436593563 |
|---|---|
| Medicare Enrollment ID | O20240216002685 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942081872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Christy Karabetian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780159491 PECOS PAC ID: 4486992914 Enrollment ID: I20190208000099 |
| Provider Name | Reya Tarannum Hossain |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376103937 PECOS PAC ID: 0547604688 Enrollment ID: I20240216003055 |
| Provider Name | Rebecca Hope Zellers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265156871 PECOS PAC ID: 1759725310 Enrollment ID: I20240222000881 |
| Provider Name | Abraham Tatis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780165290 PECOS PAC ID: 9638514102 Enrollment ID: I20240224000361 |
| Provider Name | Christian Michael Wehner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174378319 PECOS PAC ID: 8224470992 Enrollment ID: I20240527000107 |
| Provider Name | Rebecca Danielle Masterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083111033 PECOS PAC ID: 7719329325 Enrollment ID: I20240529000815 |
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