NPIMap

Organization Active NPI

Bellaire Ellie Clinic PC

Doing business as Ellie Mental Health

  • Mental Health Counselor
  • Bellaire, TX
National Provider Identifier
1487372132
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BELLAIRE ELLIE CLINIC PC
Doing business as
Ellie Mental Health
Practice address
6300 West Loop S Ste 110
Bellaire, TX 77401-2919
Phone
(832) 924-0348
Fax
(832) 852-5754
NPI assigned
Aug 18, 2022
Last updated
Sep 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Jeniffer K Esclovon, LPC-SNPI 1649510694
Title
Owner
Phone
(409) 626-1329

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

6300 West Loop S Ste 110
Bellaire, TX 77401-2919

Mailing address

6300 West Loop S Ste 110
Bellaire, TX 77401-2919
Phone (832) 924-0348

Other practice location 1

1775 Saint James Pl Ste 325
Houston, TX 77056-3416
Phone (832) 780-3497

Other practice location 2

1160 Dairy Ashford Rd Ste 601
Houston, TX 77079-3000
Phone (281) 645-5264

Other practice location 3

2200 Space Park Dr Ste 240
Houston, TX 77058-3881
Phone (281) 779-8619

Other names 1

  • Ellie Mental Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230731000122 TX Part B Supplier - Clinic/Group Practice 4981065596 Receives reassigned benefits from 15 practitioners
Practice locations: Bellaire, TX; Houston, TX

National Provider Directory

National Provider Directory

Locations

1160 Dairy Ashford Rd
Ste 601
Houston, TX 77079
Phone (281) 645-5264

2323 S Shepherd Dr
Ste 850
Houston, TX 77019
Phone (469) 560-6594

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1487372132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 WEST LOOP S STE 110",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774012919",
            "telephone_number": "832-924-0348",
            "fax_number": "832-852-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 WEST LOOP S STE 110",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774012919",
            "telephone_number": "832-924-0348",
            "fax_number": "832-852-5754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Saint James Pl Ste 325",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770563416",
            "country_code": "US",
            "telephone_number": "832-780-3497",
            "fax_number": "281-779-8619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1160 Dairy Ashford Rd Ste 601",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770793000",
            "country_code": "US",
            "telephone_number": "281-645-5264",
            "fax_number": "832-852-5754",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Space Park Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770583881",
            "country_code": "US",
            "telephone_number": "281-779-8619",
            "fax_number": "832-852-5754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BELLAIRE ELLIE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "ESCLOVON",
        "authorized_official_first_name": "JENIFFER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-626-1329",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "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 Bellaire, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.