Provider Demographics
NPI:1467542332
Name:HERLING, ELLEN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:
Last Name:HERLING
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 WASHINGTON SQ
Mailing Address - Street 2:UNIT F 34
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061
Mailing Address - Country:US
Mailing Address - Phone:781-871-8753
Mailing Address - Fax:781-871-3398
Practice Address - Street 1:80 WASHINGTON SQ
Practice Address - Street 2:UNIT F 34
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061
Practice Address - Country:US
Practice Address - Phone:781-871-8753
Practice Address - Fax:781-871-3398
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1077851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA457742OtherTUFTS HEALTH PLAN
MAP07451OtherBLUE CROSS BLUE SHIELD
MA457742OtherTUFTS HEALTH PLAN