| Ellie Mental Health | |
|
7500 W 160th St Ste 100 Stilwell KS 66085-8100 | |
| (913) 747-4960 | |
| (913) 423-1230 |
| Full Name | Ellie Mental Health |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 7500 W 160th St Ste 100, Stilwell, Kansas |
| Authorized Official Name and Position | Timothy Cole (OWNER) |
| Authorized Official Contact | 9137474960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health 7500 W 160th St Ste 100 Stilwell KS 66085-8100 Ph: (913) 747-4960 | Ellie Mental Health 7500 W 160th St Ste 100 Stilwell KS 66085-8100 Ph: (913) 747-4960 |
| NPI Number | 1700589306 |
|---|---|
| Provider Enumeration Date | 03/23/2023 |
| Last Update Date | 04/03/2024 |
| Certification Date | 04/03/2024 |
| Medicare PECOS PAC ID | 2062850993 |
|---|---|
| Medicare Enrollment ID | O20240410003124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700589306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Timothy L Cole |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1750511317 PECOS PAC ID: 7416395348 Enrollment ID: I20240410003173 |
| Provider Name | Susan Marie Chase |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174988109 PECOS PAC ID: 1759729684 Enrollment ID: I20240410003244 |
| Provider Name | Stephanie Anne Elliott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821385048 PECOS PAC ID: 2567802531 Enrollment ID: I20240425000189 |