Provider Demographics
NPI:1649496308
Name:HOROWITZ, ELLEN G (PHD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:G
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 ETHAN ALLEN HWY
Mailing Address - Street 2:SUITE # 5
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2813
Mailing Address - Country:US
Mailing Address - Phone:203-438-4793
Mailing Address - Fax:
Practice Address - Street 1:898 ETHAN ALLEN HWY
Practice Address - Street 2:SUITE # 5
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-2813
Practice Address - Country:US
Practice Address - Phone:203-438-4793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002422103TB0200X, 103TC2200X, 103TF0000X, 103TP2701X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist