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General NPI Number Information
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NPI Number | 1740270396
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Entity Type | Individual
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Provider Name | ELLEN BARUCH-VOGT LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 100 N VILLAGE AVE SUITE 27
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-3767
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Country | US
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Telephone | 516-826-2794
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Fax |
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Provider Business Mailing Address
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Address Line | 2859 JANET AVE
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-2025
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Country | US
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Telephone | 516-826-3235
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R022215-1
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License Number State | NY
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