Marguerite Kearney Ellenbaum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW019412 Issued in PA

Practice address

101 Phoenixville Pike
Malvern, PA 19355-1046

Phone

(445) 444-3546

NPI assigned

Jul 21, 2015

Last updated

May 18, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Meg Ellenbaum Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1164807046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PHOENIXVILLE PIKE",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PHOENIXVILLE PIKE",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551046",
            "telephone_number": "445-444-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBAUM",
        "first_name": "MARGUERITE",
        "middle_name": "KEARNEY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW129575",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEG",
            "last_name": "ELLENBAUM",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brenda L Eaton, BCBA
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• Kimberly C Edmonds, M.S., CCC-SLP
• Ali Ibrahim El-Kerdi, PHD, PT, ATC
• Courtney Rosaire Elgindy, CRNP
• Ellie Main Line LLC (Ellie Mental Health)
• Aleksandr Emerel, D.P.M.
• Gary David English, MS, LPC
• M Hossein Etezady, MD
• Evercare Health Solutions

• Clinical Social Worker in Malvern, PA
• Providers in Malvern, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.