Provider Demographics
NPI:1972666055
Name:HENSCHEL, ELLEN JOAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:JOAN
Last Name:HENSCHEL
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 1:565 BROADWAY
Mailing Address - Street 2:APT. 6B
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-1730
Mailing Address - Country:US
Mailing Address - Phone:914-478-4431
Mailing Address - Fax:914-478-7978
Practice Address - Street 1:425 E 86TH ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-6449
Practice Address - Country:US
Practice Address - Phone:212-369-7885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR040738-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN9C501Medicare ID - Type Unspecified