Individual provider Active NPI

Ellen J Love, LCSW

  • Psychologist
  • New York, NY
National Provider Identifier
1942241617
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
R0540831 Issued in NY
Practice address
96 5TH Ave
Suite 1K
New York, NY 10011-7605
Phone
(917) 446-7112
NPI assigned
Jun 10, 2006
Last updated
Mar 12, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X R0540831 NY Primary

Addresses

Primary practice location

96 5TH Ave
Suite 1K
New York, NY 10011-7605

Mailing address

515 E 89TH Street
4K
New York, NY 10128
Phone (212) 860-3949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20060412000686 NY Practitioner - Clinical Social Worker 6406865807 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

245 E 13TH St
New York, NY 10003-5642
Phone (917) 446-7112

515 E 89TH St
4K
New York, NY 10128-7910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0540831NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1942241617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E 89TH STREET",
            "address_2": "4K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10128",
            "telephone_number": "212-860-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 5TH AVE",
            "address_2": "SUITE 1K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117605",
            "telephone_number": "917-446-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE",
        "first_name": "ELLEN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "R0540831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.