Individual
MRS. ELLEN BAMBRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
18 RODNEY PL, ROCKVILLE CENTRE, NY 11570-5822
(516) 382-6425
Mailing address
18 RODNEY PL, ROCKVILLE CENTRE, NY 11570-5822
(516) 382-6425
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5962
NY
1041C0700X
Clinical Social Worker
R059464
NY
Other
Enumeration date
10/17/2005
Last updated
11/21/2011
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