Provider Demographics
NPI:1295785319
Name:UBER, ELLEN S (LCSW)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:S
Last Name:UBER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 491
Mailing Address - Street 2:
Mailing Address - City:ISLAND HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08732-0491
Mailing Address - Country:US
Mailing Address - Phone:732-309-4897
Mailing Address - Fax:
Practice Address - Street 1:710 EASTON AVE
Practice Address - Street 2:STE D
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1855
Practice Address - Country:US
Practice Address - Phone:732-309-4897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053151001041C0700X
NJ44SL053013001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC05315100OtherLCSW - LICENSE
NJ44SL05301300OtherLICENSE