Provider Demographics
NPI:1427419050
Name:MADRIS, EMILY (LMHC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MADRIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 E 78TH ST APT 5R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1707
Mailing Address - Country:US
Mailing Address - Phone:914-572-7748
Mailing Address - Fax:
Practice Address - Street 1:413 E 78TH ST APT 5R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1707
Practice Address - Country:US
Practice Address - Phone:914-572-7748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-09
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007106172V00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No172V00000XOther Service ProvidersCommunity Health Worker