| Ellie Mental Health | |
|
2853 Executive Park Dr Weston FL 33331-3656 | |
| (954) 800-2686 | |
| Not Available |
| Full Name | Ellie Mental Health |
|---|---|
| Speciality | Social Worker |
| Location | 2853 Executive Park Dr, Weston, Florida |
| Authorized Official Name and Position | Benjamin Marchant (OWNER) |
| Authorized Official Contact | 2066185560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health 1703 Ne 5th St Fort Lauderdale FL 33301-1325 Ph: () - | Ellie Mental Health 2853 Executive Park Dr Weston FL 33331-3656 Ph: (954) 800-2686 |
| NPI Number | 1346967122 |
|---|---|
| Provider Enumeration Date | 10/24/2022 |
| Last Update Date | 05/10/2024 |
| Certification Date | 05/10/2024 |
| Medicare PECOS PAC ID | 3476928185 |
|---|---|
| Medicare Enrollment ID | O20230412000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346967122 | NPI | - | NPPES |
| 116901400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Keara Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063187094 PECOS PAC ID: 4385049535 Enrollment ID: I20210825003695 |
| Provider Name | Tiara Lee Leavitt- Celestina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396240826 PECOS PAC ID: 6204225907 Enrollment ID: I20211118002244 |
| Provider Name | Lauren Leigh Alman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508309394 PECOS PAC ID: 5395106280 Enrollment ID: I20230725000898 |
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