MEDICARE: ELLA GALE MCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MHC00259-A	RI

General Provider Information

NPI Number	:	1083420558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLA GALE MCA

Provider Business Mailing Address
First Line	:	58 GESLER ST APT 3
Second Line	:	APT 3
City	:	PROVIDENCE
State	:	RI
Zip	:	02909-1506
Country	:	US
Telephone Number	:	917-833-5957
Fax Number	:

Provider Business Practice Location Address
First Line	:	2756 POST RD
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-3077
Country	:	US
Telephone Number	:	401-296-3686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2024
Last Update Date	:	03/23/2026

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Directions to “ ELLA GALE MCA” Practice Location

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