Donna Elise Ellenbogen

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078097-1 Issued in NY

Practice address

152 E 84TH St
New York, NY 10028-2025

Phone

(917) 612-2720

NPI assigned

Jun 25, 2020

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": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1912523945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 WESTMOUNT DR",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394230",
            "telephone_number": "917-612-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 E 84TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100282025",
            "telephone_number": "917-612-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBOGEN",
        "first_name": "DONNA",
        "middle_name": "ELISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC85210000",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078097-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole M Ellen, P.T.
• Jack Ellenberg, MD
• Leah Rachel Ellenberg, O.D.
• Luke Grisha Ellenberg, C.A.S.A.C.
• Amy Abigail Ellenbogen, M.S.W.
• Glenn C. Ellenbogen
• Nicole Danielle Ellenbogen
• Lora Ellenson, M.D.
• Alexandra Eller
• Christina Eller, LMHC MSED

• Clinical Social Worker in New York, NY
• Providers in New York, 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 Jun 25, 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.