National Provider Identifier
Ellen Peterson, LCSW
Ellen Peterson, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Ithaca, NY and a listed phone number of (607) 793-4668.
Profile Overview
- NPI
- 1760972350
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- May 18, 2018
- Last Updated
- May 18, 2018
Practice Location
- 402 N Cayuga St
- Ithaca, NY 14850-4291
Phone: (607) 793-4668
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1760972350
- Entity Type
- Individual
- Last Name
- Peterson
- First Name
- Ellen
- Credential
- LCSW
- Mailing Street Address
- 402 N Cayuga St
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-4291
- Mailing Country
- US
- Mailing Phone
- (607) 793-4668
- Practice Street Address
- 402 N Cayuga St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-4291
- Practice Country
- US
- Practice Phone
- (607) 793-4668
- Enumeration Date
- May 18, 2018
- Last Updated
- May 18, 2018
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)