Provider Demographics
NPI:1073166377
Name:FERNANDEZ ORAMA, YEIMILY (LCSW)
Entity Type:Individual
Prefix:
First Name:YEIMILY
Middle Name:
Last Name:FERNANDEZ ORAMA
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 1:140 HIGH ST FL 4
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01105-1442
Mailing Address - Country:US
Mailing Address - Phone:413-452-3200
Mailing Address - Fax:
Practice Address - Street 1:140 HIGH ST FL 4
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105-1442
Practice Address - Country:US
Practice Address - Phone:413-452-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226322104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1134107113Medicaid
MA12529OtherHNE
MAY10086OtherMEDICARE
MA1134107113OtherBEACON
MA997303OtherNETWORK HEALTH
MA1134107113OtherMBHP
MA1134107113OtherNHP
MA042622756OtherCCA
MA1134107113OtherFALLON
MA71756OtherTUFTS