Healthcare Provider Details

I. General information

NPI: 1730665829
Provider Name (Legal Business Name): ELLEN ANELLO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 NORTH RD APT 3
WARREN NJ
07059-7184
US

IV. Provider business mailing address

2 NORTH RD APT 3
WARREN NJ
07059-7184
US

V. Phone/Fax

Practice location:
  • Phone: 862-276-1881
  • Fax:
Mailing address:
  • Phone: 862-276-1881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04815600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: