| Ellie Mental Health Of Montgomery County | |
|
8120 Woodmont Ave Ste 840 Bethesda MD 20814-2789 | |
| (240) 618-2889 | |
| (240) 623-9858 |
| Full Name | Ellie Mental Health Of Montgomery County |
|---|---|
| Speciality | Clinic/Center |
| Location | 8120 Woodmont Ave Ste 840, Bethesda, Maryland |
| Authorized Official Name and Position | Shahzad Dastgir (OWNER) |
| Authorized Official Contact | 2023609183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health Of Montgomery County 21512 New Hampshire Ave Brookeville MD 20833-1841 Ph: (202) 360-9183 | Ellie Mental Health Of Montgomery County 8120 Woodmont Ave Ste 840 Bethesda MD 20814-2789 Ph: (240) 618-2889 |
| NPI Number | 1699407460 |
|---|---|
| Provider Enumeration Date | 06/29/2022 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Medicare PECOS PAC ID | 6103294939 |
|---|---|
| Medicare Enrollment ID | O20221128003013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699407460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Rachael Arowolo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780110106 PECOS PAC ID: 1355703638 Enrollment ID: I20230818000029 |
| Provider Name | Christopher Hawks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770122673 PECOS PAC ID: 2365890324 Enrollment ID: I20231130003733 |
| Provider Name | Emily Ann Vasseur |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174169098 PECOS PAC ID: 5092164228 Enrollment ID: I20231213000256 |
| Provider Name | Elissa Lopez Inthisane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710406004 PECOS PAC ID: 9133562747 Enrollment ID: I20240212001044 |
| Provider Name | Selen M Saydam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215593744 PECOS PAC ID: 6305289919 Enrollment ID: I20240212001093 |
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