| Ellie Mental Health | |
|
4001 Prince William Pkwy Ste 301 Woodbridge VA 22192-7667 | |
| (202) 390-4243 | |
| Not Available |
| Full Name | Ellie Mental Health |
|---|---|
| Speciality | Social Worker |
| Location | 4001 Prince William Pkwy Ste 301, Woodbridge, Virginia |
| Authorized Official Name and Position | Jonathan Collegio (OWNER) |
| Authorized Official Contact | 2023904243 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health 421 E Columbia St Falls Church VA 22046-3502 Ph: (202) 390-4243 | Ellie Mental Health 4001 Prince William Pkwy Ste 301 Woodbridge VA 22192-7667 Ph: (202) 390-4243 |
| NPI Number | 1962103549 |
|---|---|
| Provider Enumeration Date | 03/13/2023 |
| Last Update Date | 06/22/2023 |
| Certification Date | 06/22/2023 |
| Medicare PECOS PAC ID | 5395104319 |
|---|---|
| Medicare Enrollment ID | O20230707002998 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962103549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Patrick J Curley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649655077 PECOS PAC ID: 2961704218 Enrollment ID: I20160105000209 |
| Provider Name | Laura Schoenborn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235918053 PECOS PAC ID: 3577900463 Enrollment ID: I20240327003094 |
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