Provider Demographics
NPI:1497407936
Name:GARY, EMILY G (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:G
Last Name:GARY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22924-0292
Mailing Address - Country:US
Mailing Address - Phone:434-242-8065
Mailing Address - Fax:
Practice Address - Street 1:800 E HIGH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5126
Practice Address - Country:US
Practice Address - Phone:434-260-1510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040133331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical