| Ellie Mental Health - Space Coast | |
|
6769 N Wickham Rd # B101 Melbourne FL 32940-2048 | |
| (321) 525-1103 | |
| (833) 767-2919 |
| Full Name | Ellie Mental Health - Space Coast |
|---|---|
| Speciality | Social Worker |
| Location | 6769 N Wickham Rd # B101, Melbourne, Florida |
| Authorized Official Name and Position | Michael Mosley (VICE PRESIDENT) |
| Authorized Official Contact | 3215251103 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health - Space Coast 6769 N Wickham Rd Ste B101 Melbourne FL 32940-2048 Ph: (321) 241-4286 | Ellie Mental Health - Space Coast 6769 N Wickham Rd # B101 Melbourne FL 32940-2048 Ph: (321) 525-1103 |
| NPI Number | 1831945484 |
|---|---|
| Provider Enumeration Date | 04/25/2024 |
| Last Update Date | 03/05/2025 |
| Certification Date | 03/05/2025 |
| Medicare PECOS PAC ID | 9436698040 |
|---|---|
| Medicare Enrollment ID | O20240827004266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831945484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (NU) | Secondary |
| 1041C0700X | Social Worker - Clinical | (NU) | Primary |
| 106H00000X | Marriage & Family Therapist | (NU) | Secondary |
| Provider Name | Melissa Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841040474 PECOS PAC ID: 2567803919 Enrollment ID: I20240515004537 |
| Provider Name | Joseph Patrick Barry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750761748 PECOS PAC ID: 7416496039 Enrollment ID: I20240827004413 |
| Provider Name | Abby Elizabeth Pease |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861868085 PECOS PAC ID: 8426597030 Enrollment ID: I20240828000547 |
| Provider Name | Elizabeth Rene Nyberg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154689693 PECOS PAC ID: 9830630805 Enrollment ID: I20240917004456 |
| Provider Name | Heidi Mobley Cole |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750959854 PECOS PAC ID: 7618405846 Enrollment ID: I20250115001640 |
| Provider Name | Grace E Henry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104631977 PECOS PAC ID: 3072033406 Enrollment ID: I20250227003964 |
| Provider Name | Shelby Bliss |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1487197570 PECOS PAC ID: 9335675677 Enrollment ID: I20250324003405 |
| Provider Name | Ruth Olmstead |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700182987 PECOS PAC ID: 8325561186 Enrollment ID: I20250402001495 |
| Provider Name | John Ickowski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659157717 PECOS PAC ID: 0446759419 Enrollment ID: I20250816000425 |
| Provider Name | Cynthia Faye Krause |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1124728696 PECOS PAC ID: 9537669825 Enrollment ID: I20250821002688 |
| Provider Name | Montanna K Williamson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144036617 PECOS PAC ID: 2163998519 Enrollment ID: I20260414002911 |
| Provider Name | Raquel a Santana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770453904 PECOS PAC ID: 7416427232 Enrollment ID: I20260521003228 |
Riverside Counseling Services, LLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1301 W Eau Gallie Blvd Ste 96, Melbourne, FL 32935 Phone: 321-421-6992 Fax: 321-421-6993 |
Ams Psychiatry, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6767 N Wickham Rd, Suite 306, Melbourne, FL 32940 Phone: 321-751-1925 Fax: 321-751-9261 |
Ann L. Riebe, Psy.d., P.A. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 E Strawbridge Ave, Melbourne, FL 32901 Phone: 321-956-1515 Fax: 321-956-2336 |
David and Goliath Therapy Solutions LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2347 Kamin Dr, Melbourne, FL 32940 Phone: 843-615-3924 |
Waters Edge Psychotherapy LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1301 W Eau Gallie Blvd, Melbourne, FL 32935 Phone: 321-373-3744 |
The Sonder Academy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 475 S John Rodes Blvd, Melbourne, FL 32904 Phone: 321-241-1170 Fax: 321-241-1171 |