| Ellie Mental Health | |
|
875 Massachusetts Ave Ste 4 Cambridge MA 02139-3067 | |
| (617) 812-1697 | |
| (617) 812-1697 |
| Full Name | Ellie Mental Health |
|---|---|
| Speciality | Social Worker |
| Location | 875 Massachusetts Ave Ste 4, Cambridge, Massachusetts |
| Authorized Official Name and Position | Kayley Walsh (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7818355733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health 875 Massachusetts Ave Ste 4 Cambridge MA 02139-3067 Ph: (513) 638-2323 | Ellie Mental Health 875 Massachusetts Ave Ste 4 Cambridge MA 02139-3067 Ph: (617) 812-1697 |
| NPI Number | 1356052641 |
|---|---|
| Provider Enumeration Date | 12/08/2022 |
| Last Update Date | 03/16/2023 |
| Certification Date | 03/16/2023 |
| Medicare PECOS PAC ID | 1456716067 |
|---|---|
| Medicare Enrollment ID | O20230504001716 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356052641 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kayley E. Walsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356859037 PECOS PAC ID: 5698171676 Enrollment ID: I20210831002783 |
| Provider Name | Kristen Elisabeth Devoe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891203121 PECOS PAC ID: 7113384322 Enrollment ID: I20230602001655 |
| Provider Name | Caroline Sheahan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205541836 PECOS PAC ID: 8325407323 Enrollment ID: I20230710000826 |
| Provider Name | Molly Jane Schwartz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760917595 PECOS PAC ID: 8527422625 Enrollment ID: I20230907002754 |
| Provider Name | Jordan Nicole Kaufman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386321537 PECOS PAC ID: 2062863780 Enrollment ID: I20240108000813 |
| Provider Name | Brianna Leigh Brennan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689209603 PECOS PAC ID: 1658722392 Enrollment ID: I20240108003457 |
| Provider Name | Christina Anne Fields |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831766005 PECOS PAC ID: 6002259033 Enrollment ID: I20240207001108 |
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