Individual provider Active NPI

Ellen Ozarow Brown, LCSW

  • Clinical Social Worker
  • Ballston Lake, NY
National Provider Identifier
1316003445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R017056 Issued in NY
Practice address
315 Ushers Rd
Northway 10 Executive Park
Ballston Lake, NY 12019-1547
Phone
(518) 877-0582
Fax
(518) 877-8812
NPI assigned
Jan 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R017056 NY Primary

Addresses

Primary practice location

315 Ushers Rd
Northway 10 Executive Park
Ballston Lake, NY 12019-1547

Mailing address

315 Ushers Rd
Northway 10 Executive Park
Ballston Lake, NY 12019-1547
Phone (518) 877-0582

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R017056NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316003445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 USHERS RD",
            "address_2": "NORTHWAY 10 EXECUTIVE PARK",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120191547",
            "telephone_number": "518-877-0582",
            "fax_number": "518-877-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 USHERS RD",
            "address_2": "NORTHWAY 10 EXECUTIVE PARK",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120191547",
            "telephone_number": "518-877-0582",
            "fax_number": "518-877-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ELLEN",
        "middle_name": "OZAROW",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R017056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Lake, NY

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.