NPIMap

Organization Active NPI

Authentic Practice LLC

Doing business as Ellie Mental Health

  • Clinical Social Worker
  • Pittsfield, MA
National Provider Identifier
1508694605
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
AUTHENTIC PRACTICE LLC
Doing business as
Ellie Mental Health
Practice address
66 West St
Pittsfield, MA 01201-5861
Phone
(612) 203-4285
NPI assigned
Jul 22, 2024
Last updated
Jul 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Bertel McElrath, LPCC, LMHCNPI 1134538101
Title
Owner
Phone
(612) 203-4285

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
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

66 West St
Pittsfield, MA 01201-5861

Mailing address

66 West St
Pittsfield, MA 01201-5861
Phone (612) 203-4285

Other names 1

  • Ellie Mental Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241015002248 MA Part B Supplier - Clinic/Group Practice 4486186434 Receives reassigned benefits from 3 practitioners
Practice locations: Pittsfield, MA

National Provider Directory

National Provider Directory

Locations

66 West St
Pittsfield, MA 01201
Phone (413) 343-4264

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1508694605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 WEST ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012015861",
            "telephone_number": "612-203-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 WEST ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012015861",
            "telephone_number": "612-203-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "MCELRATH",
        "authorized_official_first_name": "BERTEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-203-4285",
        "authorized_official_credential": "LPCC, LMHC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.