Provider Demographics
NPI:1508594516
Name:EMILIE STEINNAGEL
Entity Type:Organization
Organization Name:EMILIE STEINNAGEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:EMILIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINNAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:475-252-8848
Mailing Address - Street 1:500 E MAIN ST STE 322
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-2929
Mailing Address - Country:US
Mailing Address - Phone:475-252-8848
Mailing Address - Fax:
Practice Address - Street 1:500 E MAIN ST STE 322
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-2929
Practice Address - Country:US
Practice Address - Phone:475-252-8848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT009062OtherSTATE OF CT DEPARTMENT OF PUBLIC HEALTH
1205144078OtherNPI