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General NPI Number Information
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NPI Number | 1437164241
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Entity Type | Individual
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Provider Name | ELLEN MINDY SPLAVER LCSW, LCADC
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Gender | Female
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 450 TILTON RD STE 250
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1260
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Country | US
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Telephone | 609-457-5854
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Fax |
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Provider Business Mailing Address
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Address Line | 23 N GILMAR CIR
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City | MARGATE CITY
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State | NJ
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Zip | 08402-1676
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Country | US
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Telephone | 609-823-4962
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00092100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05168500
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License Number State | NJ
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