Provider Demographics
NPI:1578087581
Name:GROSOVSKY, ELLEN HANDMAKER (LCSW, PSYA)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:HANDMAKER
Last Name:GROSOVSKY
Suffix:
Gender:F
Credentials:LCSW, PSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 KNOLL RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1024
Mailing Address - Country:US
Mailing Address - Phone:201-567-5184
Mailing Address - Fax:
Practice Address - Street 1:101 CEDAR LN STE 304
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4417
Practice Address - Country:US
Practice Address - Phone:201-310-0584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057367001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical