Provider Demographics
NPI:1225670524
Name:LURIE, EMMANUELLE (LMSW)
Entity Type:Individual
Prefix:
First Name:EMMANUELLE
Middle Name:
Last Name:LURIE
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 1:209 GRAND ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5404
Mailing Address - Country:US
Mailing Address - Phone:202-271-4485
Mailing Address - Fax:
Practice Address - Street 1:209 GRAND ST APT 5A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5404
Practice Address - Country:US
Practice Address - Phone:202-271-4485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105088104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker