Healthcare Provider Details

I. General information

NPI: 1962306597
Provider Name (Legal Business Name): ELLIS MENTAL HEALTH CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13470 S ARAPAHO DR STE 180
OLATHE KS
66062-1656
US

IV. Provider business mailing address

10420 S RIDGEVIEW RD # 1033
OLATHE KS
66061-6438
US

V. Phone/Fax

Practice location:
  • Phone: 913-421-3366
  • Fax:
Mailing address:
  • Phone: 913-421-3366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALIYAH ELLIS
Title or Position: OWNER
Credential: APRN, PMHNP-BC
Phone: 913-421-3366