Provider Demographics
NPI:1306646781
Name:TORTOISE MENTAL HEALTH, PLLC
Entity type:Organization
Organization Name:TORTOISE MENTAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:804-532-5147
Mailing Address - Street 1:10431 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23238-5101
Mailing Address - Country:US
Mailing Address - Phone:804-532-5147
Mailing Address - Fax:804-369-8818
Practice Address - Street 1:10431 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238-5101
Practice Address - Country:US
Practice Address - Phone:804-532-5147
Practice Address - Fax:804-369-8818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1063020170OtherCMS