Active NPI
Ellen Jean Resnik, M.A., LMHC, LMFT
- Mental Health Counselor
- Brookline, MA
National Provider Identifier
1821145129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 369
- Practice address
- 496 Harvard St
Brookline, MA 02446-2435 - Phone
- (617) 739-5939
- Fax
- (617) 734-5375
- NPI assigned
- Jan 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 369 | MA | Primary |
Addresses
Primary practice location
496 Harvard St
Brookline, MA 02446-2435
Mailing address
33 Clark Rd
Brookline, MA 02445-6029
Phone (617) 277-2160
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 347294 | Other | MA | MAGELLAN |
| 012897 | Other | MA | VALUE OPTIONS |
| 014602 | Other | MA | HARVARD PILGRIM |
| LM0199 | Other | MA | BLUE CROSS BLUE SHIELD |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 369 | MA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821145129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 CLARK RD",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024456029",
"telephone_number": "617-277-2160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 HARVARD ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024462435",
"telephone_number": "617-739-5939",
"fax_number": "617-734-5375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESNIK",
"first_name": "ELLEN",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "M.A., LMHC, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "369",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "347294",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "012897",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "014602",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "LM0199",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
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.