Organization
24LINCOLN, LLC
Active
Other names
Ellie Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
SARA PETRIE (OWNER)
(719) 433-5710
Entity
Organization
Contact information
Practice address
77 3RD ST STE 400, MONUMENT, CO 80132-8179
(719) 433-5710
Mailing address
15740 PAIUTE CIR, MONUMENT, CO 80132-6092
(719) 433-5710
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/26/2022
Last updated
02/20/2024
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