Provider Demographics
NPI:1740798388
Name:LITTMAN, ELLEN BETH
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:BETH
Last Name:LITTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2973
Mailing Address - Country:US
Mailing Address - Phone:914-244-1704
Mailing Address - Fax:914-244-6373
Practice Address - Street 1:175 E MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2973
Practice Address - Country:US
Practice Address - Phone:914-244-1704
Practice Address - Fax:914-244-6373
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011870-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical