Provider Demographics
NPI:1699407460
Name:ONE MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:ONE MENTAL HEALTH LLC
Other - Org Name:ELLIE MENTAL HEALTH OF MONTGOMERY COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:DASTGIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-360-9183
Mailing Address - Street 1:21512 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-1841
Mailing Address - Country:US
Mailing Address - Phone:202-360-9183
Mailing Address - Fax:
Practice Address - Street 1:8120 WOODMONT AVE STE 840
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2789
Practice Address - Country:US
Practice Address - Phone:240-618-2889
Practice Address - Fax:240-623-9858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health