Provider Demographics
NPI:1417062001
Name:SOREL, EMILY RUTH (MSW/LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:RUTH
Last Name:SOREL
Suffix:
Gender:F
Credentials:MSW/LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2498 SLATERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SLATERVILLE SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14881-9403
Mailing Address - Country:US
Mailing Address - Phone:607-227-0784
Mailing Address - Fax:607-539-6724
Practice Address - Street 1:2498 SLATERVILLE RD
Practice Address - Street 2:
Practice Address - City:SLATERVILLE SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14881-9403
Practice Address - Country:US
Practice Address - Phone:607-227-0784
Practice Address - Fax:607-539-6724
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30230R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB5790Medicare ID - Type Unspecified