| Ellie Of Avl Central, Pllc | |
|
77 Central Ave Ste C Asheville NC 28801-2451 | |
| (864) 208-5352 | |
| Not Available |
| Full Name | Ellie Of Avl Central, Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 77 Central Ave Ste C, Asheville, North Carolina |
| Authorized Official Name and Position | Patrick Mcenroe (OWNER) |
| Authorized Official Contact | 8642085352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Of Avl Central, Pllc 77 Central Ave Ste C Asheville NC 28801-2451 Ph: (864) 208-5352 | Ellie Of Avl Central, Pllc 77 Central Ave Ste C Asheville NC 28801-2451 Ph: (864) 208-5352 |
| NPI Number | 1194506204 |
|---|---|
| Provider Enumeration Date | 10/13/2023 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Medicare PECOS PAC ID | 6507308970 |
|---|---|
| Medicare Enrollment ID | O20240613000469 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194506204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Terri Patrice Wishon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427256387 PECOS PAC ID: 2365844891 Enrollment ID: I20210707000971 |
| Provider Name | Allison Anna Ramirez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114417979 PECOS PAC ID: 0042752412 Enrollment ID: I20240613002620 |
| Provider Name | Johnathon Blake Crooks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881369627 PECOS PAC ID: 8820536204 Enrollment ID: I20240815004634 |
| Provider Name | Kathryn Kelley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437824786 PECOS PAC ID: 9739620774 Enrollment ID: I20240918001973 |
| Provider Name | Maryanne Mcallister Lineberger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487465530 PECOS PAC ID: 1759805567 Enrollment ID: I20250414000872 |
| Provider Name | Abigale Alisha Teed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750038774 PECOS PAC ID: 4587180757 Enrollment ID: I20250430002212 |
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