Amy Abigail Ellenbogen, M.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

063049 Issued in NY

Practice address

175 E 94TH St
New York, NY 10128-2905

Phone

(917) 674-3421

NPI assigned

Nov 3, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Resilience Psychotherapy LCSW PC

  • Clinical Social Worker
  • New York, NY
  • NPI 1003459694
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1093470098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 56TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203409",
            "telephone_number": "718-965-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E 94TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282905",
            "telephone_number": "917-674-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBOGEN",
        "first_name": "AMY",
        "middle_name": "ABIGAIL",
        "credential": "M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "063049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Mellow MD, PLLC
• Nicole M Ellen, P.T.
• Jack Ellenberg, MD
• Leah Rachel Ellenberg, O.D.
• Luke Grisha Ellenberg, C.A.S.A.C.
• Donna Elise Ellenbogen
• Glenn C. Ellenbogen
• Nicole Danielle Ellenbogen
• Lora Ellenson, M.D.
• Alexandra Eller

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.