Individual
ELLEN EPSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1205 E MAXWELL LN, BLOOMINGTON, IN 47401-5073
(812) 333-4120
Mailing address
1205 E MAXWELL LN, BLOOMINGTON, IN 47401-5073
(812) 333-4120
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001353A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000208802
ANTHEM
IN
Enumeration date
02/09/2006
Last updated
06/21/2012
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