NPIMap

Organization Active NPI

QC Wellness Collective, PLLC

Doing business as Ellie Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charlotte, NC
National Provider Identifier
1942905575
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
QC WELLNESS COLLECTIVE, PLLC
Doing business as
Ellie Mental Health
Practice address
6115 Park South Dr Ste 135
Charlotte, NC 28210-3269
Phone
(704) 562-8717
NPI assigned
Apr 3, 2023
Last updated
Aug 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Authorized official

Name
Stacie L Macarthur, PH.DNPI 1164574182
Title
Owner/Clinical Director
Phone
(704) 364-4002

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 Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

6115 Park South Dr Ste 135
Charlotte, NC 28210-3269

Mailing address

6424 Cameron Forest LN Apt 1B
Charlotte, NC 28210-5055
Phone (704) 562-8717

Other names 1

  • Ellie Mental Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241003000313 NC Part B Supplier - Clinic/Group Practice 7012448947 Receives reassigned benefits from 10 practitioners
Practice locations: Charlotte, NC; Gastonia, NC

National Provider Directory

National Provider Directory

Locations

6115 Park South Dr
Ste 135
Charlotte, NC 28210
Phone (704) 285-0241

8832 Blakeney Professional Dr
Ste 300
Charlotte, NC 28277
Phone (980) 446-3567

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1942905575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6424 CAMERON FOREST LN APT 1B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282105055",
            "telephone_number": "704-562-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 PARK SOUTH DR STE 135",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103269",
            "telephone_number": "704-562-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QC WELLNESS COLLECTIVE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "MACARTHUR",
        "authorized_official_first_name": "STACIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "704-364-4002",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.