Provider Demographics
NPI:1821702481
Name:ELROI MENTAL HEALTH SERVICES PLLC
Entity Type:Organization
Organization Name:ELROI MENTAL HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:253-300-3303
Mailing Address - Street 1:7836 RIVERVIEW CT SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6804
Mailing Address - Country:US
Mailing Address - Phone:253-300-3303
Mailing Address - Fax:
Practice Address - Street 1:4405 7TH AVE SE STE 200-0501
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1062
Practice Address - Country:US
Practice Address - Phone:253-300-3303
Practice Address - Fax:253-300-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty