NPIMap

Organization Active NPI

Ellie Mental Health - North Central Alabama LLC

Doing business as Ellie Mental Health

  • Mental Health Counselor
  • Mountain BRK, AL
National Provider Identifier
1922793314
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ELLIE MENTAL HEALTH - NORTH CENTRAL ALABAMA LLC
Doing business as
Ellie Mental Health
Practice address
4420 Corinth Dr
Mountain BRK, AL 35213-1816
Phone
(205) 613-3429
NPI assigned
Apr 10, 2023
Last updated
Apr 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Authorized official

Name
Davis Slate Mange
Title
Owner
Phone
(205) 613-3429

Specialties & licenses 1

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

Addresses

Primary practice location

4420 Corinth Dr
Mountain BRK, AL 35213-1816

Mailing address

4420 Corinth Dr
Mountain BRK, AL 35213-1816
Phone (205) 613-3429

Other names 1

  • Ellie Mental Health Doing business as

National Provider Directory

National Provider Directory

Locations

1 Chase Corporate Dr
Ste 110
Hoover, AL 35244
Phone (205) 905-8497

Practitioners & affiliated clinicians

Practitioners 4

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": "1681084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1922793314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 CORINTH DR",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352131816",
            "telephone_number": "205-613-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 CORINTH DR",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352131816",
            "telephone_number": "205-613-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIE MENTAL HEALTH - NORTH CENTRAL ALABAMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A",
        "authorized_official_last_name": "MANGE",
        "authorized_official_first_name": "DAVIS",
        "authorized_official_middle_name": "SLATE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-613-3429"
    },
    "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"
        }
    ]
}

Other providers in Mountain BRK, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.