Provider Demographics
NPI:1609907609
Name:DECKOFF, ELLEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:
Last Name:DECKOFF
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 1:4 EPHRAIM RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-1621
Mailing Address - Country:US
Mailing Address - Phone:609-208-2044
Mailing Address - Fax:609-208-2045
Practice Address - Street 1:4 EPHRAIM RD
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08510-1621
Practice Address - Country:US
Practice Address - Phone:609-208-2044
Practice Address - Fax:609-208-2045
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051791001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical