| Doctor Name: | MRS. ELLEN SCHLOSSBERG EISEN |
| NPI Number: | 1003142670 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | C5883 |
| Business Practice Address: | 7710 Wolf River Cir Germantown, TN - 381381734 |
| Business Phone Number: | 9016855969 |
| Business Fax Number: | 9016810306 |
| Mailing Address: | 7710 Wolf River Cir, GERMANTOWN |
| State: | TN |
| Postal Code: | 381381734 |
| Phone Number: | 9016855969 |
| Fax Number: | 9016810306 |
| NPI Enumeration Date: | 11/02/2009 |
| NPI Last Update Date: | 11/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C5883 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |