Provider Demographics
NPI:1477229599
Name:KIRSCHBAUM, EMILY M (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:KIRSCHBAUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:KIRSCHBAUM
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2224 E PLEASANT RUN PARKWAY NORTH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-2118
Mailing Address - Country:US
Mailing Address - Phone:248-496-6189
Mailing Address - Fax:
Practice Address - Street 1:720 ESKENAZI AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5187
Practice Address - Country:US
Practice Address - Phone:317-880-7666
Practice Address - Fax:317-880-0448
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008656A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical