| Ellie Mental Health | |
|
2151 Emrick Blvd Ste 201 Bethlehem PA 18020-8039 | |
| (319) 400-4473 | |
| Not Available |
| Full Name | Ellie Mental Health |
|---|---|
| Speciality | Social Worker |
| Location | 2151 Emrick Blvd Ste 201, Bethlehem, Pennsylvania |
| Authorized Official Name and Position | Thu Ra (OWNER) |
| Authorized Official Contact | 3194004473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health 2584 Raya Way Easton PA 18045-5687 | Ellie Mental Health 2151 Emrick Blvd Ste 201 Bethlehem PA 18020-8039 Ph: (319) 400-4473 |
| NPI Number | 1801636386 |
|---|---|
| Provider Enumeration Date | 05/30/2024 |
| Last Update Date | 05/30/2024 |
| Certification Date | 05/30/2024 |
| Medicare PECOS PAC ID | 0446799175 |
|---|---|
| Medicare Enrollment ID | O20240827000634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801636386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Leslie Ann Tenbroeck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982817185 PECOS PAC ID: 5496104119 Enrollment ID: I20231206004136 |
| Provider Name | Paulina a Santibanez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174385546 PECOS PAC ID: 8527401363 Enrollment ID: I20240208000853 |
| Provider Name | Eric Anthony Drosnock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275294274 PECOS PAC ID: 3779022421 Enrollment ID: I20240827001164 |
| Provider Name | Christopher Tate Santos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386327617 PECOS PAC ID: 7810436474 Enrollment ID: I20240827001858 |
| Provider Name | Janine Michelle Cope |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770674053 PECOS PAC ID: 1254862659 Enrollment ID: I20241008004560 |
| Provider Name | Kelly Nicole O'hanlon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841900495 PECOS PAC ID: 3173051794 Enrollment ID: I20250110000828 |
| Provider Name | Marcey Blaine Wilder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053915751 PECOS PAC ID: 9638607815 Enrollment ID: I20250115003975 |
| Provider Name | Jody a Gilvary |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174082416 PECOS PAC ID: 2668901950 Enrollment ID: I20250131001243 |
| Provider Name | Paloma Bianca Ortiz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962216994 PECOS PAC ID: 6103336417 Enrollment ID: I20250606000881 |
| Provider Name | Beth Peters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568098390 PECOS PAC ID: 7214438779 Enrollment ID: I20250827004090 |
| Provider Name | Alexa Cruz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679341556 PECOS PAC ID: 7012406549 Enrollment ID: I20251027000551 |
| Provider Name | Jason Cox |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730062191 PECOS PAC ID: 3375034739 Enrollment ID: I20251113000820 |
| Provider Name | Christina Powell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427922095 PECOS PAC ID: 3577043959 Enrollment ID: I20260216000217 |
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