Provider Demographics
NPI:1407181944
Name:TREST, ELLEN (LCSW)
Entity type:Individual
Prefix:MISS
First Name:ELLEN
Middle Name:
Last Name:TREST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:DR
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:TREST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2438 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1910
Mailing Address - Country:US
Mailing Address - Phone:718-646-4024
Mailing Address - Fax:718-332-7978
Practice Address - Street 1:1309 FOSTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1511
Practice Address - Country:US
Practice Address - Phone:718-282-0010
Practice Address - Fax:718-693-4490
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0696161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical