| Ellie Mental Health | |
|
430 Woodruff Rd Ste 450 Greenville SC 29607-3443 | |
| (864) 275-8421 | |
| Not Available |
| Full Name | Ellie Mental Health |
|---|---|
| Speciality | Social Worker |
| Location | 430 Woodruff Rd Ste 450, Greenville, South Carolina |
| Authorized Official Name and Position | Dennis D. Chou (OWNER) |
| Authorized Official Contact | 8642758421 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Mental Health 430 Woodruff Rd Ste 450 Greenville SC 29607-3443 Ph: (864) 659-6670 | Ellie Mental Health 430 Woodruff Rd Ste 450 Greenville SC 29607-3443 Ph: (864) 275-8421 |
| NPI Number | 1457073694 |
|---|---|
| Provider Enumeration Date | 09/14/2022 |
| Last Update Date | 03/14/2023 |
| Certification Date | 03/14/2023 |
| Medicare PECOS PAC ID | 3577938224 |
|---|---|
| Medicare Enrollment ID | O20230411000910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457073694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Deborah J Whittemore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972744795 PECOS PAC ID: 5799832036 Enrollment ID: I20150730011941 |
| Provider Name | Laura L Vail |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801452727 PECOS PAC ID: 0244561850 Enrollment ID: I20191014000978 |
| Provider Name | Cecil G Plumley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659334647 PECOS PAC ID: 5395168645 Enrollment ID: I20200706002090 |
| Provider Name | Annie Laurie Forrest |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841531373 PECOS PAC ID: 1254710155 Enrollment ID: I20220623002316 |
| Provider Name | Kayla Gail Anthony |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194196576 PECOS PAC ID: 9739531658 Enrollment ID: I20240116004438 |
| Provider Name | Daniela Marie Hatter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447735873 PECOS PAC ID: 9032561964 Enrollment ID: I20240117000011 |
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