Organization
FAMILY MENTAL HEALTH OF VIRGINIA, LLC
Active
Other names
Ellie Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN COLLEGIO (OWNER)
(202) 390-4243
Entity
Organization
Contact information
Practice address
4001 PRINCE WILLIAM PKWY STE 301, WOODBRIDGE, VA 22192-7667
(202) 390-4243
Mailing address
421 E COLUMBIA ST, FALLS CHURCH, VA 22046-3502
(202) 390-4243
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/13/2023
Last updated
06/22/2023
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