NPIMap

Organization Active NPI

Momentum Mental Health LLC

Doing business as Ellie Mental Health

  • Mental Health Counselor
  • Falmouth, ME
National Provider Identifier
1033801675
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MOMENTUM MENTAL HEALTH LLC
Doing business as
Ellie Mental Health
Practice address
50 Depot Rd
Falmouth, ME 04105-1211
Phone
(207) 835-3616
NPI assigned
May 23, 2023
Last updated
Mar 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Richard Arthur Mardoian
Title
Owner
Phone
(610) 504-5821

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

50 Depot Rd
Falmouth, ME 04105-1211

Mailing address

50 Depot Rd Ste 2
Falmouth, ME 04105-1211
Phone (207) 835-3616

Other names 1

  • Ellie Mental Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231229001402 ME Part B Supplier - Clinic/Group Practice 0749630986 Receives reassigned benefits from 6 practitioners
Practice locations: Falmouth, ME

National Provider Directory

National Provider Directory

Locations

50 Depot Rd
Falmouth, ME 04105
Phone (207) 781-8881

50 Depot Rd
Ste 2
Falmouth, ME 04105
Phone (207) 391-3167

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1033801675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 DEPOT RD STE 2",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041051211",
            "telephone_number": "207-835-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 DEPOT RD",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041051211",
            "telephone_number": "207-835-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-23",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "MARDOIAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-504-5821",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ellie Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Falmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.