Provider Demographics
NPI:1942379375
Name:FLAUM, ELLEN B (LCSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:B
Last Name:FLAUM
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 1:1825 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-8902
Mailing Address - Country:US
Mailing Address - Phone:561-968-1505
Mailing Address - Fax:561-968-1565
Practice Address - Street 1:1825 FOREST HILL BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-8902
Practice Address - Country:US
Practice Address - Phone:561-968-1505
Practice Address - Fax:561-968-1565
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ2563Medicare ID - Type Unspecified