NPI | 1528752037 |
---|---|
Doing Business As | ELLIE MENTAL HEALTH |
Entity Type | Organization |
Authorized Contact | KRISTIN DUTKA Owner 910-515-1340 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional | |
103T00000X Psychologist | |
1041C0700X Social Worker, Clinical | |
Enumeration Date | 2023-06-07 |
Last Update Date | 2024-04-04 |