Provider Demographics
NPI:1043096316
Name:GALVIN, EMMA ADELE (LMSW)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:ADELE
Last Name:GALVIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 FULTON ST RM 1004
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-2528
Mailing Address - Country:US
Mailing Address - Phone:917-426-2111
Mailing Address - Fax:
Practice Address - Street 1:139 FULTON ST RM 1004
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2528
Practice Address - Country:US
Practice Address - Phone:917-426-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120853-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical