Provider Demographics
NPI:1770790131
Name:HOROVITZ, ELLEN GAIL (ATR-BC, LCAT)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:GAIL
Last Name:HOROVITZ
Suffix:
Gender:F
Credentials:ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CANALSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1347
Mailing Address - Country:US
Mailing Address - Phone:585-704-1890
Mailing Address - Fax:
Practice Address - Street 1:2 CANALSIDE DR
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1347
Practice Address - Country:US
Practice Address - Phone:585-704-1890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05 000467101YM0800X, 221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY101YM0800XOtherCOUNSELOR, MENTAL HEALTH
NY05 000467OtherART THERAPY LICENSE