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ELLIE MENTAL HEALTH
NPI 1528752037
Clinic/Center - Mental Health (Including Community Mental Health Center) in Malvern, PA

Active since June 07, 2023
1200 ATWATER DR STE 130, MALVERN, PA 19355(610) 646-1851(484) 355-5181 Get Directions Write a Review

NPPES record last updated: April 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 4, 2024, Jun 7, 2023 (2 updates tracked since 2023).

About Ellie Mental Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELLIE MENTAL HEALTH (NPI 1528752037) is a healthcare organization registered as a mental health (including community mental health center) in Malvern, Pennsylvania and active in the NPI registry since June 2023. The organization lists Kristin Dutka, Owner, as its authorized official.

NPPES Registry Identity

NPI1528752037
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameELLIE MAIN LINE LLC
Location Address1200 ATWATER DR STE 130Malvern, PA 19355-8782
Mailing Address392 Merlin RdPhoenixville, PA 19460-2109 · (910) 515-1340
Phone(610) 646-1851
Fax(484) 355-5181
Organization SubpartNo
Authorized OfficialKristin DutkaOwner · (910) 515-1340
Enumeration DateJune 7, 2023
Last NPPES UpdateApril 4, 20242 updates tracked since enumeration
NPPES CertifiedApril 3, 2024
✔ NPI 1528752037 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X
Also ListedPsychologistTaxonomy 103T00000X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
1200 ATWATER DR STE 130, Malvern, PA 19355
Open in Google Maps ↗

Other Names 1

Doing Business AsEllie Mental Health

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ellie Mental Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Ellie Mental Health, which bills Medicare for the services they deliver. Of these, 8 practice at this address. They are listed nearest first.

Clinicians, nearest first (8)

Gary English, MS, LPC
Mental Health Counselor
NPI 1437346954
1200 ATWATER DR STE 130
Malvern, PA 19355
(610) 632-7745
✔ PECOSSame address
Anna Frederick, MSSW, LCSW
Clinical Social Worker
NPI 1336250612
1200 ATWATER DR STE 130
Malvern, PA 19355
(610) 646-1851
✔ PECOS✔ Accepts MedicareSame address
Dana Greenlee, MS, LPC
Mental Health Counselor
NPI 1295507267
1200 ATWATER DR STE 130
Malvern, PA 19355
(610) 646-1851
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Knowlton, LPC, MA
Mental Health Counselor
NPI 1922332949
1200 ATWATER DR STE 130
Malvern, PA 19355
(610) 646-1851
✔ PECOSSame address
Jenna Mercadante, PSYD
Clinical Psychologist
NPI 1851721104
1200 ATWATER DR STE 130
Malvern, PA 19355
(610) 646-1851
✔ PECOS✔ Accepts MedicareSame address
Rose Montgomery, MSW, LCSW
Clinical Social Worker
NPI 1124626254
1200 ATWATER DR STE 130
Malvern, PA 19355
(610) 646-1851
✔ PECOS✔ Accepts MedicareSame address
Emily Stone, MS, LPC
Mental Health Counselor
NPI 1184028805
1200 ATWATER DR STE 130
Malvern, PA 19355
(610) 646-1851
✔ PECOS✔ Accepts MedicareSame address
Thomas De Vitis, MA, LPC
Mental Health Counselor
NPI 1831750611
1200 ATWATER DR STE 130
Malvern, PA 19355
(610) 646-1851
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ellie Main Line LLC's NPI number?

The NPI number for Ellie Main Line LLC is 1528752037. It was assigned to this organization in the NPPES registry on June 7, 2023. The provider is doing business as Ellie Mental Health.

Where is Ellie Main Line LLC located?

Ellie Main Line LLC is located at 1200 Atwater Dr Ste 130, Malvern, PA 19355. The listed phone number is (610) 646-1851.

What is Ellie Main Line LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Ellie Main Line LLC enrolled in Medicare?

Yes. Ellie Main Line LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ellie Main Line LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Ellie Main Line LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Mental Health Counselor (5), Clinical Social Worker (2) and Clinical Psychologist (1). Of these, 8 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Ellie Main Line LLC was last updated on April 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.