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General NPI Number Information
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NPI Number | 1023823853
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Entity Type | Organization
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Legal Business Name | ELLIE MENTAL HEALTH OF RHODE ISLAND, PC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 1526 ATWOOD AVE
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City | JOHNSON
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State | RI
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Zip | 02911
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Country | US
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Telephone | 617-875-8987
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Fax |
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Provider Business Mailing Address
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Address Line | 1526 ATWOOD AVE
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City | JOHNSTON
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State | RI
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Zip | 02919-3289
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Country | US
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Telephone | 617-875-8987
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Fax | 402-223-9613
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | MICHELE DRISLANE
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Credential |
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Telephone | 617-875-8987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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