Provider Demographics
NPI:1265691091
Name:MAZER, ELLEN (LICSW, LGSW)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:
Last Name:MAZER
Suffix:
Gender:F
Credentials:LICSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 38TH ST NW
Mailing Address - Street 2:UNIT F270
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2914
Mailing Address - Country:US
Mailing Address - Phone:202-841-4860
Mailing Address - Fax:
Practice Address - Street 1:3610 38TH ST NW
Practice Address - Street 2:UNIT F270
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2914
Practice Address - Country:US
Practice Address - Phone:202-841-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500784711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical