Provider Demographics
NPI:1366845869
Name:MOST, ELLEN G
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:G
Last Name:MOST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:GROSSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1753 DECATUR RD
Mailing Address - Street 2:
Mailing Address - City:MOHEGAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:10547-1629
Mailing Address - Country:US
Mailing Address - Phone:914-439-0922
Mailing Address - Fax:
Practice Address - Street 1:1753 DECATUR RD
Practice Address - Street 2:
Practice Address - City:MOHEGAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:10547-1629
Practice Address - Country:US
Practice Address - Phone:914-439-0922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0929488104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker