Ellen Gottlich, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC00039300 Issued in NJ

Practice address

600 New Rd
Northfield, NJ 08225-1653

Phone

(609) 641-2500

Fax

(609) 641-2502

NPI assigned

Oct 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Ellen Waldman Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Affiliates in PsychotherapyGroup PAC ID 0547222549, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Affiliates in Psychotherapy

  • Clinical Social Worker
  • Northfield, NJ
  • NPI 1689608903
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932294790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 E LAKE FRONT CIR",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082053314",
            "telephone_number": "609-652-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NEW RD",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251653",
            "telephone_number": "609-641-2500",
            "fax_number": "609-641-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLICH",
        "first_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00039300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "WALDMAN",
            "prefix": "MS.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Garden State Specialty Care, LLC
• Generations Family Medicine
• Adam Ross Gillman, D.C.
• Bruce Gitto, LPC
• Joseph Gitto, D.C.
• Brett Robert Gottman, OTR/L
• Steven L Gough, MSW, LSW
• Lashawna Green
• Nickcole Marie Green
• Barbara Greenling, APN-C

• Clinical Social Worker in Northfield, NJ
• Providers in Northfield, NJ by specialty
• Clinical Social Worker in New Jersey

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.