# FAMILY MENTAL HEALTH OF VIRGINIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ellie Mental Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962103549
- **Authorized official:** MR. JONATHAN COLLEGIO (OWNER)
- **Authorized official phone:** (202) 390-4243

## Contact information

- **Practice address:** 4001 PRINCE WILLIAM PKWY STE 301, WOODBRIDGE, VA 22192-7667
- **Practice address phone:** (202) 390-4243
- **Mailing address:** 421 E COLUMBIA ST, FALLS CHURCH, VA 22046-3502
- **Mailing address phone:** (202) 390-4243

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2023
- **Last updated:** 06/22/2023