| Ellison Mental Health Services Pllc | |
|
530 Oak Ridge Way E West Fargo ND 58078-8417 | |
| (701) 491-2651 | |
| Not Available |
| Full Name | Ellison Mental Health Services Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 530 Oak Ridge Way E, West Fargo, North Dakota |
| Authorized Official Name and Position | Jo Ellison (OWNER) |
| Authorized Official Contact | 7014912651 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellison Mental Health Services Pllc 530 Oak Ridge Way E West Fargo ND 58078-8417 Ph: (701) 491-2651 | Ellison Mental Health Services Pllc 530 Oak Ridge Way E West Fargo ND 58078-8417 Ph: (701) 491-2651 |
| NPI Number | 1821878919 |
|---|---|
| Provider Enumeration Date | 10/05/2023 |
| Last Update Date | 10/05/2023 |
| Certification Date | 10/05/2023 |
| Medicare PECOS PAC ID | 9638515240 |
|---|---|
| Medicare Enrollment ID | O20240306000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821878919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Jo Ellison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841532942 PECOS PAC ID: 1153631924 Enrollment ID: I20151106000281 |
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