Provider Demographics
NPI:1942605258
Name:HACKETT, ELLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:HACKETT
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 1:1380 ALBANY POST RD
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-1558
Mailing Address - Country:US
Mailing Address - Phone:914-960-3334
Mailing Address - Fax:914-827-0158
Practice Address - Street 1:1380 ALBANY POST RD
Practice Address - Street 2:SUITE 1D
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-1558
Practice Address - Country:US
Practice Address - Phone:914-960-3334
Practice Address - Fax:914-827-0158
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0821521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical