Provider Demographics
NPI:1366891079
Name:SCHENZER, ELLEN (LMFT)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:
Last Name:SCHENZER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:375 MATHER ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-3101
Mailing Address - Country:US
Mailing Address - Phone:203-417-6594
Mailing Address - Fax:
Practice Address - Street 1:375 MATHER ST
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-3101
Practice Address - Country:US
Practice Address - Phone:203-417-6594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001096106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherNONE