Active NPI
Dorothea Ellern, LMSW
- Clinical Social Worker
- Brooklyn, NY
National Provider Identifier
1447395934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 008430
- Practice address
- 2581 Atlantic Ave
Brooklyn, NY 11207-2412 - Phone
- (718) 495-6700
- Fax
- (718) 485-4018
- NPI assigned
- Feb 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 008430 | NY | Primary |
Addresses
Primary practice location
2581 Atlantic Ave
Brooklyn, NY 11207-2412
Mailing address
90 Riverside Dr
Apartment No. 12F
New York, NY 10024-5306
Phone (212) 877-2087
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
| License | State | Type | Specialty |
|---|---|---|---|
| 008430 | NY | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute for Community Living , Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Brooklyn, NY
- NPI 1558494930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447395934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 RIVERSIDE DR",
"address_2": "APARTMENT NO. 12F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100245306",
"telephone_number": "212-877-2087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2581 ATLANTIC AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112072412",
"telephone_number": "718-495-6700",
"fax_number": "718-485-4018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLERN",
"first_name": "DOROTHEA",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "008430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, 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.