NPIMap

Organization Active NPI

Upstate Ellie LLC

Doing business as Ellie Mental Health

  • Specialist
  • Greenville, SC
National Provider Identifier
1457073694
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
UPSTATE ELLIE LLC
Doing business as
Ellie Mental Health
Practice address
430 Woodruff Rd Ste 450
Greenville, SC 29607-3443
Phone
(864) 659-6670
Fax
(864) 818-4697
NPI assigned
Sep 14, 2022
Last updated
May 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Authorized official

Name
Kristin N Hall
Title
Operations Leader
Phone
(864) 302-6012

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU
Specialist 174400000X NU Primary
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

430 Woodruff Rd Ste 450
Greenville, SC 29607-3443

Mailing address

430 Woodruff Rd Ste 450
Greenville, SC 29607-3443
Phone (864) 659-6670

Other identifiers 1

IdentifierTypeStateIssuer
PG1594MedicaidSC

Other names 1

  • Ellie Mental Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230411000910 SC Part B Supplier - Clinic/Group Practice 3577938224 Receives reassigned benefits from 13 practitioners
Practice locations: Greenville, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777593600000",
    "number": "1457073694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 WOODRUFF RD STE 450",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073443",
            "telephone_number": "864-659-6670",
            "fax_number": "864-818-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WOODRUFF RD STE 450",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073443",
            "telephone_number": "864-659-6670",
            "fax_number": "864-818-4697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE ELLIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-14",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OPERATIONS LEADER",
        "authorized_official_telephone_number": "864-302-6012"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PG1594",
            "state": "SC"
        }
    ],
    "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 Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.