Ellice Jane Berson, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R025852-1 Issued in NY

Practice address

910 E 172ND St
Bronx, NY 10460-5802

Phone

(347) 767-2200

NPI assigned

Apr 17, 2013

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1871937110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 E 172ND ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104605802",
            "telephone_number": "347-767-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 E 172ND ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104605802",
            "telephone_number": "347-767-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSON",
        "first_name": "ELLICE",
        "middle_name": "JANE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "025852",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R025852-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Frederick Berry
• Kyla Lauren Berry, LCAT, ATR-BC
• Natasha Antoinette Berry, PA
• Wayne Phillip Berry, PA
• Beth R Berson, DDS
• Tamara Berthaud, LCSW-R
• Ingrid Berthomieux, CHES
• Brandi Bertie, MD
• Lyncia Bertil, LMSW
• Jay Ira Bertin, LCSW

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.