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NPI Code Detail

MEDICARE: ELLEN MARGARET GOLDWASSER LCSW

MEDICARE: ELLEN MARGARET GOLDWASSER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker2015012173MO
21041C0700XClinical Social WorkerCSW008407GA
31041C0700XClinical Social Worker88593CA

General Provider Information

NPI Number : 1497386080
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN MARGARET GOLDWASSER LCSW
Provider Business Mailing Address
First Line : 1530 F ST UNIT 301
Second Line :
City : SACRAMENTO
State : CA
Zip : 95814-1676
Country : US
Telephone Number : 314-699-4216
Fax Number : 949-404-6103
Provider Business Practice Location Address
First Line : 5134 PEACHTREE RD
Second Line :
City : CHAMBLEE
State : GA
Zip : 30341-2724
Country : US
Telephone Number : 678-872-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2020
Last Update Date : 06/18/2026

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