MS. LARISSA ELLEN GOLLOUB (NPI# 1942352034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942352034 |
| Entity Type | Individual |
| Full Name | MS. LARISSA ELLEN GOLLOUB |
| Credential | LCSW-R |
| Practice Address |
2581 Atlantic Ave 2nd Floor Brooklyn NY 11207-2412 |
| Mailing Address |
11115 75th Ave Apt. 5m Forest Hills NY 11375-6327 |
| Practice Telephone | 7188908100 |
| Practice Fax Number | 7184958298 |
| Mailing Telephone | 7188908100 |
| Mailing Fax Number | 7184958298 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
R050308-1 | NY | Behavioral Health & Social Service Providers |
| Street Address |
2581 ATLANTIC AVE 2ND FLOOR |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11207-2412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326646548 | Sirenayka Louis | Counselor | 2581 Atlantic Ave, Brooklyn, NY 11207-2412 | 2020-10-09 |
| 1396350856 | Christopher Kevin Bruno | Student in an Organized Health Care Education/Training Program | 2581 Atlantic Ave, Brooklyn, NY 11207-2412 | 2020-09-11 |
| 1114532868 | Carolyn Weverbergh | Student in an Organized Health Care Education/Training Program | 2581 Atlantic Ave, Brooklyn, NY 11207-2412 | 2020-09-10 |
| 1922613736 | Kenneth Scott II | Student in an Organized Health Care Education/Training Program | 2581 Atlantic Ave, Brooklyn, NY 11207-2412 | 2020-09-09 |
| 1669083366 | Anjoulie Fatema Woodhead | Social Worker | 2581 Atlantic Ave, Brooklyn, NY 11207-2412 | 2020-08-14 |
| 1790309409 | Lauren Aubrey Robertson | Student in an Organized Health Care Education/Training Program | 2581 Atlantic Ave, Brooklyn, NY 11207-2412 | 2020-05-29 |
| 1629603477 | Elizabeth Grosser | Student in an Organized Health Care Education/Training Program | 2581 Atlantic Ave, Brooklyn, NY 11207-2412 | 2020-03-11 |
| 1336774348 | Yanick Francois | Student in an Organized Health Care Education/Training Program | 2581 Atlantic Ave, Brooklyn, NY 11207-2412 | 2020-03-10 |
| 1831729037 | Kimberly Lam | Social Worker | 2581 Atlantic Ave, Brooklyn, NY 11207-2412 | 2020-01-16 |
| 1316587207 | Thomas Jonathan Grant | Registered Nurse | 2581 Atlantic Ave, Brooklyn, NY 11207-2412 | 2020-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356817142 | Tajeet Singh | Licensed Practical Nurse | 174 East 51, Brooklyn, NY 11207 | 2018-10-18 |
| 1801306147 | Ebony Herring | Counselor | 2640 Pitkin Avenue, Brooklyn, NY 11207 | 2017-09-30 |
| 1780106153 | Ivonne Perry | Registered Nurse | 35 Mc Clancy Pl, Brooklyn, NY 11207 | 2017-07-07 |
| 1548700925 | Special Medical PC | Family Medicine | 699 B Stanley Avenue, Brooklyn, NY 11207 | 2017-03-03 |
| 1003368333 | Alison Deborah Kahler | Social Worker | 557 Pennsylvania Ave, Room 155, Icl School Based Program At Ps13, Brooklyn, NY 11207 | 2016-11-03 |
| 1942757836 | Melissa Santana | Counselor | Bushwick Child and Family Mental Health Center, 102 Pilling Street, Brooklyn, NY 11207 | 2016-09-08 |
| 1871943050 | Joan Murrell | Licensed Practical Nurse | 297 Bradford St, Brooklyn, NY 11207 | 2016-06-17 |
| 1386019321 | Marta Josephine Jablonka I | Peer Specialist | 137 Dewitt Ave, Brooklyn, NY 11207 | 2015-12-02 |
| 1962877076 | Uche Rosario Oboh | Pharmacist | Nyc Health & Hospitals Gotham Health Center, 2094 Pitkin Avenue, Brooklyn, NY 11207 | 2015-12-01 |
| 1467837997 | Dhalene Wharton | Licensed Practical Nurse | 540 Shefield Ave, Brooklyn, NY 11207 | 2015-07-27 |
| Find all providers in zip 11207 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770181190 | Kendall Johnson-smith | Social Worker | 108 Kenilworth Place, Comm. 2, Brooklyn, NY 11210-2439 | 2020-10-16 |
| 1316545700 | Emily Rogers | Social Worker | 28 Meserole St Apt 3, Brooklyn, NY 11206-3191 | 2020-10-16 |
| 1841898749 | Deena Grossman | Social Worker | 1014 E 29th St, Brooklyn, NY 11210-3744 | 2020-10-13 |
| 1932706413 | Brooklyn Healthy Mind 360- Nurse Practitioner In Psychiatry Pllc | Social Worker | 26 Court St Ste 409, Brooklyn, NY 11242-1134 | 2020-10-07 |
| 1184221897 | Alexandre David Bauman | Social Worker | 151 Guernsey St Apt 1r, Brooklyn, NY 11222-2848 | 2020-10-06 |
| 1538766308 | Malky Katz | Social Worker | 1621 58th St, Brooklyn, NY 11204-2174 | 2020-10-05 |
| 1881291029 | Andrea M Harris-kornblith | Social Worker | 324 Prospect Ave Apt 1l, Brooklyn, NY 11215-5526 | 2020-10-01 |
| 1255938494 | Juniper Therapeutic Services LLC | Social Worker | 524 Lafayette Ave Apt 4, Brooklyn, NY 11205-4948 | 2020-10-01 |
| 1154938512 | Victor Furtick | Social Worker | 461 Dean St Apt 12p, Brooklyn, NY 11217-4144 | 2020-09-29 |
| 1700493376 | Coral Hain | Social Worker | 830 Marcy Ave Apt 2, Brooklyn, NY 11216-1524 | 2020-09-28 |
| Find all providers in BROOKLYN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.