Individual provider Active NPI

Ellyn Lipschutz Gamberg, ED.D., LMHC

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1871871632
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
000225-1 Issued in NY
Practice address
501 5TH Ave RM 1411
New York, NY 10017-7867
Phone
(212) 286-8777
NPI assigned
Jul 28, 2011
Last updated
Jul 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 000225-1 NY Primary
Mental Health Counselor 101YM0800X MH5140 FL

Addresses

Primary practice location

501 5TH Ave RM 1411
New York, NY 10017-7867

Mailing address

501 5TH Ave RM 1411
New York, NY 10017-7867
Phone (212) 286-8777

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
MH5140FLMDMental Health Counselor
000225-1NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1871871632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 5TH AVE RM 1411",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100177867",
            "telephone_number": "212-286-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 5TH AVE RM 1411",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100177867",
            "telephone_number": "212-286-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSCHUTZ GAMBERG",
        "first_name": "ELLYN",
        "name_prefix": "Dr.",
        "credential": "ED.D., LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000225-1",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5140",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.