Provider Demographics
NPI:1346567971
Name:EMMER-MARTIN, LAURIE JILL (LICSW, MSW, LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:JILL
Last Name:EMMER-MARTIN
Suffix:
Gender:F
Credentials:LICSW, MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 GREENWICH ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-1613
Mailing Address - Country:US
Mailing Address - Phone:202-210-4869
Mailing Address - Fax:
Practice Address - Street 1:1660 L ST NW STE 503
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5667
Practice Address - Country:US
Practice Address - Phone:202-728-1166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC30007491041C0700X
MD115951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical