Provider Demographics
NPI:1164440004
Name:VERNY, ELLEN (LMSW-R)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:VERNY
Suffix:
Gender:F
Credentials:LMSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 A KINGS HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1805
Mailing Address - Country:US
Mailing Address - Phone:718-382-0045
Mailing Address - Fax:718-382-0051
Practice Address - Street 1:2925 A KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1805
Practice Address - Country:US
Practice Address - Phone:718-382-0045
Practice Address - Fax:718-382-0051
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR055683104100000X
NYR055683-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN5J411NYMedicare UPIN
NYN5J411Medicare ID - Type Unspecified