Provider Demographics
NPI:1972670339
Name:SANSCHAGRIN, ELLEN MCVEY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:MCVEY
Last Name:SANSCHAGRIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ELLEN
Other - Middle Name:LOUISE
Other - Last Name:MCVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:826 SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4408
Mailing Address - Country:US
Mailing Address - Phone:760-436-1883
Mailing Address - Fax:760-436-9862
Practice Address - Street 1:826 SECOND STREET
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4408
Practice Address - Country:US
Practice Address - Phone:760-436-1883
Practice Address - Fax:760-436-9862
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS11666104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18105Medicare PIN