Ellen Gussaroff, LCSW, PH.D.

Primary specialty

PsychoanalystTaxonomy code 102L00000X

License

R0281851 Issued in NY

Practice address

120 E 36TH St
Ste #1H
New York, NY 10016-3465

Phone

(212) 686-1547

NPI assigned

Apr 12, 2007

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 24, 2017 through May 24, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124242953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E 36TH ST",
            "address_2": "STE #1H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163465",
            "telephone_number": "212-686-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 36TH ST",
            "address_2": "STE #1H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163465",
            "telephone_number": "212-686-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSSAROFF",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "LCSW, PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "R0281851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Gushen, DPT
• George V Gushue, PH.D.
• Paraschiva Gusita, D.M.D.
• Paul Gusmorino, M.D.
• Jeffrey Richard Guss, MD
• Ann Marie Gustafson, MD
• Greta H. Gustafson, LCSW
• Danielle Alberte Gustama, NURSE PRACTITIONER
• Amy Stack Gustavson, MS, LMHC
• Kiersten Danielle Gustavson, RN

• Psychoanalyst in New York, NY
• Providers in New York, NY by specialty
• Psychoanalyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.