Ellen E Wijnberg, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW4967 Issued in FL

Practice address

6600 University Pkwy Ste 304
Sarasota, FL 34240-9048

Phone

(833) 769-3524

NPI assigned

Nov 17, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• GPS II

  • Health Service Psychologist
  • Longboat Key, FL
  • NPI 1861740888
  NPD (past)
• John P McDonough III

  dba Geriatric Psychological Specialists

  • Psychologist
  • Tampa, FL
  • NPI 1346280161
  NPD (past)
• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1255405932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 UNIVERSITY PKWY STE 304",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342409048",
            "telephone_number": "833-769-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 UNIVERSITY PKWY STE 304",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342409048",
            "telephone_number": "833-769-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJNBERG",
        "first_name": "ELLEN",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005629",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany C Wierzba, PHD
• Wilhelmine Wiese-Rometsch, MD
• Danielle Michelina Wiggin, APRN
• Judith Ellen Wiggins, LCSW
• Wigs and Hair Extensions of Sarasota Inc.
• Tara Regina Wilcox
• Lawrence Ernest Wild, D.M.D.
• Rachel Wild
• Michelle Ann Wilde, APRN (FNP-C)
• Christine Lynn Wildeman, M.D.

• Clinical Social Worker in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.