Provider Demographics
NPI:1265821417
Name:SCHWINN, ELLEN GAYLE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:GAYLE
Last Name:SCHWINN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:ELLEN
Other - Middle Name:GAYLE
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1411 WESLEY DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7149
Mailing Address - Country:US
Mailing Address - Phone:410-642-4011
Mailing Address - Fax:410-630-1654
Practice Address - Street 1:1104 HEALTHWAY DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-4469
Practice Address - Country:US
Practice Address - Phone:410-219-5483
Practice Address - Fax:410-219-5486
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22650104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid