Provider Demographics
NPI:1073817672
Name:SMITH, EMILY (LCSW-R, BCD)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW-R, BCD
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:COLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 PINE WEST PLZ STE 511
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5587
Mailing Address - Country:US
Mailing Address - Phone:518-250-9637
Mailing Address - Fax:
Practice Address - Street 1:5 PINE WEST PLZ STE 511
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5587
Practice Address - Country:US
Practice Address - Phone:518-250-9637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-22
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081127-11041C0700X
NY081385-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker