Healthcare Provider Details

I. General information

NPI: 1457282626
Provider Name (Legal Business Name): ELLEN MARANCA LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N MEADOW ST
ITHACA NY
14850-4027
US

IV. Provider business mailing address

208 N MEADOW ST
ITHACA NY
14850-4027
US

V. Phone/Fax

Practice location:
  • Phone: 607-351-2939
  • Fax:
Mailing address:
  • Phone: 607-351-2939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ELLEN MARANCA
Title or Position: PROVIDER/SOLE MEMBER
Credential: LCSW
Phone: 607-351-2939