Provider Demographics
NPI:1053647974
Name:ABRAMS, ELLEN RACHEL (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:RACHEL
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 CAYUGA ST
Mailing Address - Street 2:
Mailing Address - City:TRUMANSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14886-9106
Mailing Address - Country:US
Mailing Address - Phone:607-387-8205
Mailing Address - Fax:
Practice Address - Street 1:103 SOUTH SENECA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:607-387-8205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000602-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist