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General NPI Number Information
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NPI Number | 1619748878
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Entity Type | Organization
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Legal Business Name | ALLY MENTAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 7541 MENTOR AVE SUITES A103 & A104
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City | MENTOR
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State | OH
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Zip | 44060-5431
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Country | US
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Telephone | 440-622-3728
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Fax |
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Provider Business Mailing Address
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Address Line | 7541 MENTOR AVE STE A103
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City | MENTOR
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State | OH
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Zip | 44060-5431
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Country | US
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Telephone | 440-457-1112
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Fax | 440-457-1112
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Authorized Official
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Title or Position | MEMBER
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Name | CHRISTINA ANDERSON
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Credential |
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Telephone | 440-457-1112
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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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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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