| Ellie Mental Health | |
|
340 North Ave E Ste 1a Cranford NJ 07016-2461 | |
| (856) 298-9203 | |
| (908) 325-7793 |
| Full Name | Ellie Mental Health |
|---|---|
| Speciality | Counselor |
| Location | 340 North Ave E Ste 1a, Cranford, New Jersey |
| Authorized Official Name and Position | Jordan Faiman (CLINIC DIRECTOR) |
| Authorized Official Contact | 8562989203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health 340 North Ave E Ste 1a Cranford NJ 07016-2461 Ph: (856) 298-9203 | Ellie Mental Health 340 North Ave E Ste 1a Cranford NJ 07016-2461 Ph: (856) 298-9203 |
| NPI Number | 1265111645 |
|---|---|
| Provider Enumeration Date | 07/13/2023 |
| Last Update Date | 02/19/2024 |
| Certification Date | 02/19/2024 |
| Medicare PECOS PAC ID | 7416392139 |
|---|---|
| Medicare Enrollment ID | O20240304001496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265111645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jordan S Faiman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689951923 PECOS PAC ID: 0143665869 Enrollment ID: I20240304001800 |
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