Provider Demographics
NPI:1033311014
Name:DAMRON, EMILY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:DAMRON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W 16TH ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6280
Mailing Address - Country:US
Mailing Address - Phone:718-768-0265
Mailing Address - Fax:
Practice Address - Street 1:125 W 16TH ST
Practice Address - Street 2:SUITE 116
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6280
Practice Address - Country:US
Practice Address - Phone:212-675-7564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR031385-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN67V3OtherEMPIRE BLUE CROSS
NYN1853OtherEMPIRE BLUE CROSS