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Organization
FAMILY MENTAL HEALTH OF VIRGINIA, LLC
Active
Organization
FAMILY MENTAL HEALTH OF VIRGINIA, LLC
Active
Other names
Ellie Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN COLLEGIO (OWNER)
(202) 390-4243
Entity
Organization
Contact information
Practice address
4001 PRINCE WILLIAM PKWY STE 301, WOODBRIDGE, VA 22192-7667
(202) 390-4243
Mailing address
421 E COLUMBIA ST, FALLS CHURCH, VA 22046-3502
(202) 390-4243
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/13/2023
Last updated
06/22/2023
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