# DTAP MENTAL HEALTH SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ellie Mental Health, Ellie PA-Havertown-Township Line Rd
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518737824
- **Authorized official:** MR. RICHARD F CUBBAGE JR. (MANAGING MEMBER)
- **Authorized official phone:** (267) 784-5118

## Contact information

- **Practice address:** 1120 W TOWNSHIP LINE RD STE 101, HAVERTOWN, PA 19083-4930
- **Practice address phone:** (267) 784-5118
- **Mailing address:** 8330 FENTON RD, GLENSIDE, PA 19038-7146
- **Mailing address phone:** (267) 784-5118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2024
- **Last updated:** 01/28/2025