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Organization

UPSTATE ELLIE LLC

Active
Other names
Ellie Mental Health
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTIN N HALL (OPERATIONS LEADER)
(864) 302-6012
Entity
Organization

Contact information

Practice address
430 WOODRUFF RD STE 450, GREENVILLE, SC 29607-3443
(864) 659-6670
(864) 818-4697
Mailing address
430 WOODRUFF RD STE 450, GREENVILLE, SC 29607-3443
(864) 659-6670
(864) 818-4697

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
174400000X
Specialist
Primary
208000000X
Pediatrics Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PG1594
SC
Enumeration date
09/14/2022
Last updated
05/01/2026
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