Ellen Berman, LCSW

Individual provider Active NPI Clinical Social Worker · Jackson, NJ

NPI 1114005444 · NPPES record last updated Feb 6, 2015

Key facts

NPI
1114005444
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SC04310900 (NJ)
Practice address
2290 W County Line Rd
Suite 206a
Jackson, NJ 08527-2267
Phone
(732) 370-5355
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
44SC04310900NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ellen Berman,LCSW Clinical Past
since Aug 31, 2015
Accepting new patients
Rutgers Health - Behavioral Health Past Accepting new patients
Rutgers Health - Behavioral Health Past Accepting new patients
Roslyn Blau LCSW LLC Clinical Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11216/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC04310900 NJ Yes

Addresses

Primary practice location

2290 W County Line Rd
Suite 206a
Jackson, NJ 08527-2267

Mailing address

2290 W County Line Rd
Suite 206a
Jackson, NJ 08527-2267
Phone (732) 370-5355

Other providers in Jackson, NJ

All providers in Jackson, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.