Provider Demographics
NPI:1073862835
Name:EMERY, TERREN M (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:TERREN
Middle Name:M
Last Name:EMERY
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 1:6 DUVAL LN
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-2723
Mailing Address - Country:US
Mailing Address - Phone:860-250-3467
Mailing Address - Fax:
Practice Address - Street 1:6 DUVAL LN
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-2723
Practice Address - Country:US
Practice Address - Phone:860-250-3467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027253501104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker