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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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