Organization
MELLAHEALTH LLC
Active
Organization
MELLAHEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVY SARA PATT PHD (LICENSED CLINICAL PSYCHOLOGIST)
(860) 810-0587
Entity
Organization
Contact information
Practice address
125 LASALLE RD STE 300, WEST HARTFORD, CT 06107-2311
(860) 342-8192
(860) 523-4225
Mailing address
125 LASALLE RD STE 300, WEST HARTFORD, CT 06107-2311
(860) 342-8192
(860) 523-4225
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
02/18/2022
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