Provider Demographics
NPI:1285622555
Name:GARBUNY, ELLEN (LSW)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:
Last Name:GARBUNY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 IRENE DR
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2767
Mailing Address - Country:US
Mailing Address - Phone:724-283-1593
Mailing Address - Fax:724-283-1134
Practice Address - Street 1:340 N MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4945
Practice Address - Country:US
Practice Address - Phone:724-283-1593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW-006537-L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker