Provider Demographics
NPI:1316003445
Name:BROWN, ELLEN OZAROW (LCSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:OZAROW
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 USHERS RD
Mailing Address - Street 2:NORTHWAY 10 EXECUTIVE PARK
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-1547
Mailing Address - Country:US
Mailing Address - Phone:518-877-0582
Mailing Address - Fax:518-877-8812
Practice Address - Street 1:315 USHERS RD
Practice Address - Street 2:NORTHWAY 10 EXECUTIVE PARK
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-1547
Practice Address - Country:US
Practice Address - Phone:518-877-0582
Practice Address - Fax:518-877-8812
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0170561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical