Provider Demographics
NPI:1790904373
Name:ELLEN BERMAN,LCSW
Entity Type:Organization
Organization Name:ELLEN BERMAN,LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-370-5355
Mailing Address - Street 1:2050 W COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2014
Mailing Address - Country:US
Mailing Address - Phone:732-370-5355
Mailing Address - Fax:
Practice Address - Street 1:2050 W COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2014
Practice Address - Country:US
Practice Address - Phone:732-370-5355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty