Healthcare Provider Details

I. General information

NPI: 1689876237
Provider Name (Legal Business Name): ELLEN S. GOLDRING ATR-BC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVE
HACKENSACK NJ
07601-1914
US

IV. Provider business mailing address

82 WINDBEAM AVE
RINGWOOD NJ
07456-1805
US

V. Phone/Fax

Practice location:
  • Phone: 201-996-5146
  • Fax: 201-487-7340
Mailing address:
  • Phone: 973-962-1043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00338400
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: