| Ellie Mental Health | |
|
238 Hoover Blvd Ste 30 Holland MI 49423-3782 | |
| (616) 312-2989 | |
| Not Available |
| Full Name | Ellie Mental Health |
|---|---|
| Speciality | Social Worker |
| Location | 238 Hoover Blvd Ste 30, Holland, Michigan |
| Authorized Official Name and Position | Rebecca Stevens (CLINIC DIRECTOR) |
| Authorized Official Contact | 6164272966 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health 238 Hoover Blvd Ste 30 Holland MI 49423-3782 Ph: (616) 312-2989 | Ellie Mental Health 238 Hoover Blvd Ste 30 Holland MI 49423-3782 Ph: (616) 312-2989 |
| NPI Number | 1093420960 |
|---|---|
| Provider Enumeration Date | 01/16/2023 |
| Last Update Date | 03/22/2023 |
| Certification Date | 03/22/2023 |
| Medicare PECOS PAC ID | 4082088588 |
|---|---|
| Medicare Enrollment ID | O20230324000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093420960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gregory R Lott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548226202 PECOS PAC ID: 1355312141 Enrollment ID: I20040804001306 |
| Provider Name | Rebecca J Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427295773 PECOS PAC ID: 0547310146 Enrollment ID: I20090602000273 |
| Provider Name | Jennifer Fopma |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780376822 PECOS PAC ID: 3577923119 Enrollment ID: I20230714001285 |
| Provider Name | Zoe C Steiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982165718 PECOS PAC ID: 2860846862 Enrollment ID: I20230925003188 |
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